Provider Demographics
NPI:1700381563
Name:LEE, ANDREW KOOK (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:KOOK
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3200 MACCORKLE AVE SE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1227
Mailing Address - Country:US
Mailing Address - Phone:304-388-8199
Mailing Address - Fax:304-388-2951
Practice Address - Street 1:3200 MACCORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1227
Practice Address - Country:US
Practice Address - Phone:304-388-8199
Practice Address - Fax:304-388-2951
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV325112086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery