Lee, Jae Won

Lee, Jae Won is an individual health care provider with primary practice located at 350 W 11Th St , Indianapolis IN 46202-4108. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology, which is considered as his primary health care specialty. Lee, Jae Won can be contacted via phone (888) 484-3258.

Contact Information

Primary practice address
350 W 11Th St Indianapolis IN 46202-4108
Phone: (888) 484-3258
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X 01099302A Indiana
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X D0102131 Maryland

Profile Details

NPI number 1497372569
LBN Legal business name Lee, Jae Won
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2020
Last updated Aug 14th, 2026 - about 2 months 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 1497372569 NPPES
Indiana MEDICAID 300131633

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