Provider Demographics
NPI:1801042833
Name:BYOUNG K. LEE, MDPA
Entity Type:Organization
Organization Name:BYOUNG K. LEE, MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-942-2474
Mailing Address - Street 1:13000 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5330
Mailing Address - Country:US
Mailing Address - Phone:301-942-2676
Mailing Address - Fax:
Practice Address - Street 1:13000 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5330
Practice Address - Country:US
Practice Address - Phone:301-942-6003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD41673501OtherRANDERING NUMBER OF CARE FIRST BLUE CROSS OF MARYLAND
MD43QMBKOtherCARE FIRST INDIVIDUAL PLAN
MD488178OtherNCPP
VA299996OtherANTHEMHEALTH KEEPER VA
MD796421800Medicaid
MD0100352OtherAMERICHOICE
DC011496600Medicaid
DC12070001OtherCARE FIRST BCBS OF DC REGION (GHMSI, BLUE CHOICE, BLUE PREFERRED, FEDERAL PLAN)
MD110005885OtherRAILROAD MEDICARE PALMETTO GBA
MD299998OtherANTHEM HEALTHKEEPER BLUE CROSS BLUE SHIELD
MD3165925OtherACCUPUNTURE SPECIALIST (ALLIANCE, OPTIMUM CHOICE, MAMSI, M.D.I.PA)
MD1383592OtherCIGNA
MD8165925OtherOPTIMUM CHOICE,MAMSI, M.D. IPA (PRIMARY PHYSICIAN)
MD0004053128OtherAETNA HMO
MD0506452OtherAETNA PPO
MD43QMBKOtherCARE FIRST BCBS (NASCO)
MD76630OtherAMERIGROUP
MD2165925OtherALLIANCE (PRIMARY PHYSICIAN)
MD0101397OtherEVERCARE
MD488178OtherNCPP
MD76630OtherAMERIGROUP
MD1383592OtherCIGNA
MD41673501OtherRANDERING NUMBER OF CARE FIRST BLUE CROSS OF MARYLAND