Provider Demographics
NPI:1588634141
Name:LEE, ESTHER JOO (MD)
Entity Type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:JOO
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1709 BERWICK DR
Mailing Address - Street 2:STE A
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5523
Mailing Address - Country:US
Mailing Address - Phone:910-276-8611
Mailing Address - Fax:910-276-9757
Practice Address - Street 1:1709 BERWICK DR
Practice Address - Street 2:STE A
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5523
Practice Address - Country:US
Practice Address - Phone:910-276-8611
Practice Address - Fax:910-276-9757
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0036212207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8951546Medicaid
NC51546OtherBCBS
NC8951546Medicaid
NC2210616DMedicare ID - Type Unspecified