Provider Demographics
NPI:1124218227
Name:LEE, WON M (MD)
Entity Type:Individual
Prefix:
First Name:WON
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:801 ALBANY STREET
Mailing Address - Street 2:FL GROUND
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 ALBANY STREET
Practice Address - Street 2:SHAPIRO 9
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-4001
Practice Address - Country:US
Practice Address - Phone:617-638-6100
Practice Address - Fax:617-638-6179
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2020-06-04
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Provider Licenses
StateLicense IDTaxonomies
MA232483207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110080592AMedicaid
MA000797501Medicare PIN