Provider Demographics
NPI:1518279066
Name:LEE, PEI SHEUN ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:PEI SHEUN
Middle Name:ANDREW
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANDREW
Other - Middle Name:PEI SHEUN
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:400 HUNTINGDON PIKE STE C
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:PA
Mailing Address - Zip Code:19046-4431
Mailing Address - Country:US
Mailing Address - Phone:215-780-2000
Mailing Address - Fax:215-780-2007
Practice Address - Street 1:400 HUNTINGDON PIKE STE C
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:PA
Practice Address - Zip Code:19046-4431
Practice Address - Country:US
Practice Address - Phone:215-780-2000
Practice Address - Fax:215-780-2007
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD449132207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA297895Medicare PIN