Kan S Lee, PH.D.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1790 Issued in MD

Practice address

19614 Club House Rd
Montgomery Village, MD 20886-3035

Phone

(301) 963-0519

Fax

(301) 963-0513

NPI assigned

Aug 20, 2012

Last updated

Aug 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

• Sam's Medical Laboratory LLC

  • Clinical Medical Laboratory
  • Montgomery Village, MD
  • NPI 1083957773
  Authorized official Same address or phone

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1275881419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19614 CLUB HOUSE RD",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208863035",
            "telephone_number": "301-963-0519",
            "fax_number": "301-963-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19614 CLUB HOUSE RD",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208863035",
            "telephone_number": "301-963-0519",
            "fax_number": "301-963-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-20",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "1790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakhvinder Wadhwa MD LLC
• Fraida Landa- Raskin
• Merrill K Lavallee, P.T.
• Karin Lawson, PT
• Lease a Mom
• Cindy Leah Leeb, AU.D.
• David Jay Levine, MD
• Charles Eric Levy, PHD
• Veronica L Linares, MD
• Lynsene Care LLC

• Clinical Medical Laboratory in Montgomery Village, MD
• Providers in Montgomery Village, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.