Provider Demographics
NPI:1851509780
Name:YARBROUGH, LEE CAPPEL (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:CAPPEL
Last Name:YARBROUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 LONG POINT RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7930
Mailing Address - Country:US
Mailing Address - Phone:843-881-0320
Mailing Address - Fax:843-856-8456
Practice Address - Street 1:570 LONG POINT RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7930
Practice Address - Country:US
Practice Address - Phone:843-881-0320
Practice Address - Fax:843-856-8456
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116017736390200000X
SC31539207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program