Myung Soo Lee, M.D.

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

C10001788 Issued in DE

Practice address

L6 Omega Dr
Newark, DE 19713-2077

Phone

(302) 738-9300

Fax

(302) 738-3791

NPI assigned

Dec 20, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Koniver Fiss Mansoory MD PA

  • Diagnostic Radiology Physician
  • Wilmington, DE
  • NPI 1083615561
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1235115429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MILLTOWN RD",
            "address_2": "SUITE 13",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198084027",
            "telephone_number": "302-993-2330",
            "fax_number": "302-993-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "L6 OMEGA DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132077",
            "telephone_number": "302-738-9300",
            "fax_number": "302-738-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MYUNG",
        "middle_name": "SOO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "DE",
            "license": "C10001788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000190701",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Y Lee, M.D.
• Ezra Lee
• Henry Millard Lee III, MD
• Megan E. Lee
• Melissa Lee
• Sharon Lee, PHD
• Stephanie A Lee, MD
• William May Lee, M.D.
• Young Ju Lee, D.O.
• Stephen J Leech, MD

• Neuroradiology Physician in Newark, DE
• Providers in Newark, DE by specialty
• Neuroradiology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.