Provider Demographics
NPI:1821074758
Name:LEE, EUN MIN (MD)
Entity Type:Individual
Prefix:
First Name:EUN
Middle Name:MIN
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1601 N TUCSON BLVD
Mailing Address - Street 2:#40
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3425
Mailing Address - Country:US
Mailing Address - Phone:520-326-6845
Mailing Address - Fax:520-326-6848
Practice Address - Street 1:1601 N TUCSON BLVD
Practice Address - Street 2:#40
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3425
Practice Address - Country:US
Practice Address - Phone:520-326-6845
Practice Address - Fax:520-326-6848
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2016-04-28
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Provider Licenses
StateLicense IDTaxonomies
AZ29485207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ139185OtherPTAN
AZZ139185OtherPTAN