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General NPI Number Information
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NPI Number | 1073889226
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Entity Type | Individual
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Provider Name | SUNG BAE JEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2012
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Last Update Date | 04/22/2019
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Provider Practice Location Address
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Address Line | 386 MERRIMACK ST STE 1C
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City | METHUEN
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State | MA
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Zip | 01844-5886
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Country | US
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Telephone | 978-688-1220
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Fax | 978-688-1330
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Provider Business Mailing Address
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Address Line | 386 MERRIMACK ST STE 1C
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City | METHUEN
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State | MA
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Zip | 01844-5886
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Country | US
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Telephone | 978-688-1220
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Fax | 978-688-1330
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 17111
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License Number State | NH
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