Provider Demographics
NPI:1134729528
Name:LEE, HYUNJOO (PHARMD)
Entity type:Individual
Prefix:
First Name:HYUNJOO
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 N STAFFORD COMPLEX CTR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-1901
Mailing Address - Country:US
Mailing Address - Phone:540-602-6119
Mailing Address - Fax:540-602-6121
Practice Address - Street 1:14 N STAFFORD COMPLEX CTR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-1901
Practice Address - Country:US
Practice Address - Phone:540-602-6119
Practice Address - Fax:540-602-6121
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH100003107183500000X
MD25355183500000X
VA0202215963183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist