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Physician Compare National (NPI:1811942857)

HEALTHCARE PROVIDER: YOON JAE LEE M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1811942857
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5698727469
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20050221000324
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name LEE
Individual professional last name
Provider First Name YOON JAE
Individual professional first name
Provider Gender M
The provider's gender if the provider is a person.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1980
Individual professional's medical school graduation year
Primary Specialty GASTROENTEROLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 3400 MCCLURE BRIDGE RD
Group Practice or individual's line 1 address
Line 2 Street Address B201
Group Practice or individual's line 2 address
City DULUTH
Group Practice or individual's city
State GA
Group Practice or individual's state
Zip Code 300968705
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 110087
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 GWINNETT MEDICAL CENTER
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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