Provider Demographics
NPI:1881629764
Name:LEE, HUNGCHIH (MD)
Entity Type:Individual
Prefix:
First Name:HUNGCHIH
Middle Name:
Last Name:LEE
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 1:7862 KINGLAND DR
Mailing Address - Street 2:STE 201E
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2573
Mailing Address - Country:US
Mailing Address - Phone:513-755-7888
Mailing Address - Fax:513-766-7400
Practice Address - Street 1:7862 KINGLAND DR STE 201
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2573
Practice Address - Country:US
Practice Address - Phone:513-755-7888
Practice Address - Fax:513-572-3014
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2022-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041624208VP0014X
OH35.078406208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2429241Medicaid
OH2741206Medicaid
OH9282354Medicare PIN
CTH78440Medicare UPIN
CT720000011Medicare ID - Type UnspecifiedMEDICARE ID
OH2741206Medicaid