Provider Demographics
NPI:1932514692
Name:LEE, DUGKEUN
Entity Type:Individual
Prefix:
First Name:DUGKEUN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5302
Mailing Address - Country:US
Mailing Address - Phone:301-656-1358
Mailing Address - Fax:301-656-1632
Practice Address - Street 1:6700 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20815-5302
Practice Address - Country:US
Practice Address - Phone:301-656-1358
Practice Address - Fax:301-656-1632
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18175183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist