Provider Demographics
NPI:1881798411
Name:LEE, NELSON CHU (DPM)
Entity type:Individual
Prefix:DR
First Name:NELSON
Middle Name:CHU
Last Name:LEE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:14408 BRADSHAW DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-6507
Mailing Address - Country:US
Mailing Address - Phone:301-384-5965
Mailing Address - Fax:301-384-5965
Practice Address - Street 1:8955 EDMONSTON RD STE G
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-4035
Practice Address - Country:US
Practice Address - Phone:301-345-5557
Practice Address - Fax:301-384-5965
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD389213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT31145Medicare UPIN