Provider Demographics
NPI:1336313733
Name:LEE, RUSHYUAN JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSHYUAN
Middle Name:JAY
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-933-1390
Practice Address - Street 1:601 N CAROLINE ST
Practice Address - Street 2:JHOC #5000
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-2394
Practice Address - Country:US
Practice Address - Phone:410-283-1573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD77661207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery