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NPI Code Detail

MEDICARE: SUNGCHAN LEE

MEDICARE:   SUNGCHAN  LEE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH032362GA

General Provider Information

NPI Number : 1811596273
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUNGCHAN LEE
Provider Business Mailing Address
First Line : 726 FULTON ST APT 353
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37402-6925
Country : US
Telephone Number : 470-455-7045
Fax Number :
Provider Business Practice Location Address
First Line : 3625 BATTLEFIELD PKWY
Second Line :
City : FORT OGLETHORPE
State : GA
Zip : 30742-4001
Country : US
Telephone Number : 706-866-1839
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2020
Last Update Date : 10/18/2020

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Directions to “ SUNGCHAN LEE ” Practice Location

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