JAE YOUNG LEE (NPI# 1104826973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104826973 |
| Entity Type | Individual |
| Full Name | JAE YOUNG LEE |
| Credential | MD |
| Practice Address |
130 Washington St Marine City MI 48039-1680 |
| Practice Telephone | 8107658844 |
| Practice Fax Number | 8107654326 |
| Mailing Telephone | 8107658844 |
| Mailing Fax Number | 8107654326 |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2011-01-14 |
| NPI Deactivation Date | 03/21/2006 |
| NPI Reactivation Date | 2006-04-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 4301033400 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1068960 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336637586 | Jae Myung Lee | Counselor | 1166 S Elmhurst Rd, Mt Prospect, IL 60056-4241 | 2018-04-24 |
| 1477098887 | Jae Lee | Acupuncturist | 955 Armory Rd, Barstow, CA 92311-5461 | 2016-12-21 |
| 1346658192 | Jae Yong Lee | Dentist | 1111 River Road, G25, Edgewater, NJ 07020-1369 | 2014-07-24 |
| 1205241320 | Jae Lee | Acupuncturist | 12411 Osborne St, Unit 45, Pacoima, CA 91331-2000 | 2014-06-26 |
| 1386067155 | Jae S Lee | Acupuncturist | 14748 Roosevelt Ave Apt 1f, Flushing, NY 11354-4709 | 2014-01-29 |
| 1609217736 | Jae Bum Lee | Dentist | 401 S Glenoaks Blvd Ste 100, Burbank, CA 91502-2707 | 2013-07-17 |
| 1699026906 | Jae Hun Lee | Pharmacist | Providence St. Peter Hospital, 413 Lilly Road N.e., Department of Pharmacy, Olympia, WA 98506 | 2012-09-26 |
| 1306194279 | Jae Hun Lee | Acupuncturist | 1630 Pleasant Hill Rd Ste C2, Duluth, GA 30096-5899 | 2012-08-26 |
| 1629332812 | Jae Young Lee | Internal Medicine | 419 N. Harrison St, Princeton, NJ 08540-4089 | 2012-07-02 |
| 1366718934 | Jae Lee | Pharmacist | 25250 Pacific Highway S, Kent, WA 98032 | 2012-03-28 |
| Street Address |
130 WASHINGTON ST |
| City | MARINE CITY |
| State | MI |
| Zip Code | 48039-1680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811155039 | Jae Young Lee Md PC | Internal Medicine | 130 Washington St, Marine City, MI 48039-1680 | 2008-05-23 |
| 1063401685 | Peter R Pashley | Internal Medicine | 130 Washington St, Marine City, MI 48039-1680 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699174813 | Family Meds Inc | Pharmacy | 302 S Water St, Marine City, MI 48039 | 2014-08-14 |
| 1609294099 | Christina Evanko | Psychologist | 6660 Starville Rd, Cottrellville, MI 48039 | 2014-04-02 |
| 1285910463 | Gerald M Wesley | Dentist | 6240 Mckinley Rd, Marine City, MI 48039 | 2011-11-01 |
| 1871523522 | Kevin Gerardd Gilbert | Chiropractor | 6640 S River Rd, Marine City, MI 48039 | 2006-07-04 |
| 1184885493 | Norbert C. Zimmer P.C. | Chiropractor | 447 S Water St, Marine City, MI 48039 | 2008-06-19 |
| 1972909323 | Gerald Wesley | Dentist | 6240 Mckinley Rd, Cottrellville, MI 48039-1119 | 2014-11-12 |
| 1295813129 | Pulsar Medical Group PC | Internal Medicine | 538 Broadway St, Marine City, MI 48039-1605 | 2006-11-01 |
| 1821133265 | St Clair County Community Mental Health Authority | Community/Behavioral Health | 135 Broadway St, Marine City, MI 48039-1607 | 2007-02-21 |
| 1811535933 | St Clair County Community Mental Health Sud Services - Marine City | Clinic/Center | 135 Broadway St, Marine City, MI 48039-1607 | 2019-12-19 |
| 1104460468 | Leigha Claerhout | Registered Nurse | 135 Broadway St, Marine City, MI 48039-1607 | 2019-10-30 |
| Find all providers in zip 48039 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295813129 | Pulsar Medical Group PC | Internal Medicine | 538 Broadway St, Marine City, MI 48039-1605 | 2006-11-01 |
| 1811155039 | Jae Young Lee Md PC | Internal Medicine | 130 Washington St, Marine City, MI 48039-1680 | 2008-05-23 |
| 1063401685 | Peter R Pashley | Internal Medicine | 130 Washington St, Marine City, MI 48039-1680 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910687 | Berry Johnson Health Pllc | Internal Medicine | 30123 Rock Creek Dr, Southfield, MI 48076-5358 | 2020-10-24 |
| 1386243178 | Hoover Internal Medicine Pllc | Internal Medicine | 4067 Georgia St, Hamtramck, MI 48212 | 2020-10-22 |
| 1790399798 | Enhua Wang | Internal Medicine | 1215 E Michigan Ave Ste 500, Lansing, MI 48912-1811 | 2020-09-07 |
| 1093329849 | Hey Doc, P.C. | Internal Medicine | 1431 Washington Blvd Apt 2510, Detroit, MI 48226-1729 | 2020-08-31 |
| 1568074375 | Mohammad Nadeemullah Pllc | Internal Medicine | 5400 Waldenhill Ct, Superior Twp, MI 48198-9654 | 2020-08-21 |
| 1356953723 | Eager Internal Medicine, Pllc | Internal Medicine | 720 N Lapeer Rd Ste 101, Lake Orion, MI 48362-4011 | 2020-08-18 |
| 1144838335 | Ranim Chamseddin | Internal Medicine | 3200 Five Points Dr Unit 110, Auburn Hills, MI 48326-2372 | 2020-07-14 |
| 1407474562 | Pravalika Rudraraju | Internal Medicine | 6245 Inkster Rd Dept Of, Garden City, MI 48135-4001 | 2020-07-06 |
| 1780200469 | Abed L Dabaja | Internal Medicine | 6245 Inkster Rd # Gme, Garden City, MI 48135-4001 | 2020-06-18 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| Find all providers with the same taxonomy | ||||
| City | MARINE CITY |
| Zip Code | 48039 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.