Lee, David Ethan

Lee, David Ethan is an individual health care provider with primary practice located at 7130 Village Medical Cir , Clemmons NC 27012-8004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Lee, David Ethan can be contacted via phone (336) 893-2420.

Contact Information

Primary practice address
7130 Village Medical Cir Clemmons NC 27012-8004
Phone: (336) 893-2420
Fax: (336) 893-2431
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2006-00237 North Carolina

Profile Details

NPI number 1578511911
LBN Legal business name Lee, David Ethan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Oct 28th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578511911 NPPES
North Carolina MEDICAID 5904219

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