Provider Demographics
NPI:1821085812
Name:LEE, HUN T (MD)
Entity Type:Individual
Prefix:
First Name:HUN
Middle Name:T
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1502 E BROADWAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8076
Mailing Address - Country:US
Mailing Address - Phone:573-443-4591
Mailing Address - Fax:573-874-1369
Practice Address - Street 1:1502 E BROADWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8076
Practice Address - Country:US
Practice Address - Phone:573-443-4591
Practice Address - Fax:573-874-1369
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOMD356022085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA13675Medicare UPIN