Provider Demographics
NPI:1003163007
Name:LEE, JAMES HYUN SOO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HYUN SOO
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 WASHINGTON ST
Mailing Address - Street 2:APARTMENT 1A
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5382
Mailing Address - Country:US
Mailing Address - Phone:610-304-4921
Mailing Address - Fax:
Practice Address - Street 1:CVN 76 USS RONALD REAGAN
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310
Practice Address - Country:US
Practice Address - Phone:610-304-4921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD446455208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery