Provider Demographics
NPI:1326171067
Name:LEE, HEE SOON (MD)
Entity Type:Individual
Prefix:DR
First Name:HEE SOON
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3753
Mailing Address - Country:US
Mailing Address - Phone:302-739-4729
Mailing Address - Fax:302-739-7735
Practice Address - Street 1:805 RIVER RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3753
Practice Address - Country:US
Practice Address - Phone:302-739-4729
Practice Address - Fax:302-739-7735
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0001614261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC48723Medicare UPIN