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General NPI Number Information
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NPI Number | 1952538522
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Entity Type | Individual
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Provider Name | LEE KIEN YONG M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2009
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 330 1ST CAPITOL DR STE 260
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City | SAINT CHARLES
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State | MO
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Zip | 63301-2888
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Country | US
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Telephone | 636-925-0900
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Fax | 636-925-0960
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Provider Business Mailing Address
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Address Line | 335 OAK STAND CT
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1310
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Country | US
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Telephone | 636-751-2042
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 2011001240
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 036123437
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License Number State | IL
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