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General NPI Number Information
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NPI Number | 1184683203
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Entity Type | Individual
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Provider Name | KANG H LEE MD
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Gender | Male
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Dates
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Enumeration Date | 03/18/2006
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Last Update Date | 07/28/2007
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Provider Practice Location Address
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Address Line | 7 N ATKINSON DR STE 113
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City | LUDINGTON
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State | MI
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Zip | 49431-1953
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Country | US
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Telephone | 231-845-7387
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Fax |
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Provider Business Mailing Address
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Address Line | 7 ATKINSON DR STE 113
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City | LUDINGTON
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State | MI
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Zip | 49431
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Country | US
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Telephone | 231-845-7387
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | KL031493
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C42491
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License Number State | CA
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