Provider Demographics
NPI:1205846854
Name:LEE, FU-NEN (MD)
Entity Type:Individual
Prefix:DR
First Name:FU-NEN
Middle Name:
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 1:2376 SOUTHEAST BLVD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-3472
Mailing Address - Country:US
Mailing Address - Phone:330-332-9989
Mailing Address - Fax:
Practice Address - Street 1:2376 SOUTHEAST BLVD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-3472
Practice Address - Country:US
Practice Address - Phone:330-332-9989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35035957207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0320174Medicaid
OH0320174Medicaid
OHC01403Medicare UPIN