Won Kyu Lee, MD

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

4301065083 Issued in MI

Practice address

2650 Horizon Dr SE
Suite 233
Grand Rapids, MI 49546-7686

Phone

(616) 419-3607

Fax

(616) 419-3679

NPI assigned

Jun 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

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

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.

• Universal Dermatopathology Lab, PLLC

  • Clinical Medical Laboratory
  • Grand Rapids, MI
  • NPI 1467723502
  NPD (past) Authorized official
• Kent Pathology Laboratory PLLC

  • Clinical Medical Laboratory
  • Grand Rapids, MI
  • NPI 1982660734
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1871538124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 HORIZON DR SE",
            "address_2": "SUITE 233",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467686",
            "telephone_number": "616-419-3607",
            "fax_number": "616-419-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 HORIZON DR SE",
            "address_2": "SUITE 233",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467686",
            "telephone_number": "616-419-3607",
            "fax_number": "616-419-3679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "WON",
        "middle_name": "KYU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "C43108",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "C43108",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "MI",
            "license": "4301065083",
            "primary": true
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "AZ",
            "license": "36275",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "C43108",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301065083",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "36275",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Lee, M.D.
• Sangjin Lee, MD, MSC
• Sheri Lee
• Truman Lee
• Victoria Lee, RN
• Rachael Nicole Leece, CTRS, QIDP
• Jennifer Leech, MA, CCC-SLP
• Christian Todd Leeman
• Mary C Leemputte, MD
• Tracy Leese

• Dermatopathology (Pathology) Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dermatopathology (Pathology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.