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NPI Code Detail

MEDICARE: DR. JONATHAN CHUANG-YIEN LEE M.D.

MEDICARE: DR. JONATHAN CHUANG-YIEN LEE M.D.
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
1207RA0401XAddiction Medicine (Internal Medicine) Physician0101247972VA
22084A0401XAddiction Medicine (Psychiatry & Neurology) Physician0101247972VA

General Provider Information

NPI Number : 1821284753
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN CHUANG-YIEN LEE M.D.
Provider Business Mailing Address
First Line : 5477 MOORETOWN RD
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23188-2108
Country : US
Telephone Number : 757-565-0106
Fax Number :
Provider Business Practice Location Address
First Line : 5477 MOORETOWN RD
Second Line : FARLEY CENTER AT WILLIAMSBURG PLACE
City : WILLIAMSBURG
State : VA
Zip : 23188-2108
Country : US
Telephone Number : 757-565-0106
Fax Number : 757-565-0620
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2007
Last Update Date : 05/09/2011

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