Provider Demographics
NPI:1649567835
Name:LEE, SEUNG YOON (MD)
Entity Type:Individual
Prefix:DR
First Name:SEUNG YOON
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CELINE
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:166 E 5900 S STE B111
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7293
Mailing Address - Country:US
Mailing Address - Phone:801-509-5722
Mailing Address - Fax:801-743-7593
Practice Address - Street 1:166 E 5900 S STE B111
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7293
Practice Address - Country:US
Practice Address - Phone:801-509-5722
Practice Address - Fax:801-743-7593
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA129491207RR0500X
UT9790378-1205207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology