MEDICARE: JUNG H LEE MD

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
1	2085R0202X	Diagnostic Radiology Physician	D0014756	MD

General Provider Information

NPI Number	:	1932199312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNG H LEE MD

Provider Business Mailing Address
First Line	:	1201 SEVEN LOCKS RD
Second Line	:	SUITE 200
City	:	ROCKVILLE
State	:	MD
Zip	:	20854-2931
Country	:	US
Telephone Number	:	301-652-5771
Fax Number	:	301-652-6332

Provider Business Practice Location Address
First Line	:	3001 HOSPITAL DR
Second Line	:
City	:	CHEVERLY
State	:	MD
Zip	:	20785-1189
Country	:	US
Telephone Number	:	301-618-3340
Fax Number	:	301-618-3964

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	07/08/2007

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