| Dr Choon K Lee, MD | |
|
18101 Oakwood Blvd, Dept Radioation Oncology Lower Level, Dearborn, MI 48124-4089 | |
| (313) 593-7337 | |
| (313) 593-8844 |
| Full Name | Dr Choon K Lee |
|---|---|
| Gender | Male |
| Speciality | Radiology - Radiation Oncology |
| Location | 18101 Oakwood Blvd, Dearborn, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508809260 | NPI | - | NPPES |
| 125079 | Other | MI | CARE CHOICES |
| CL035511 | Other | MI | BCBS |
| 300108768 | Other | RR MEDICARE | |
| 423248910 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 4301035511 (Michigan) | Primary |
| Entity Name | Beaumont Medical Group- Specialty Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578072906 PECOS PAC ID: 7214299866 Enrollment ID: O20180320002549 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Choon K Lee, MD 1420 Stephenson Hwy, Suite 400-credentialing, Troy, MI 48083-1189 Ph: (248) 581-5974 | Dr Choon K Lee, MD 18101 Oakwood Blvd, Dept Radioation Oncology Lower Level, Dearborn, MI 48124-4089 Ph: (313) 593-7337 |
Frankju A Arevalo, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 840 Oakwood Blvd, Dearborn, MI 48124 Phone: 313-359-7650 Fax: 313-359-7660 | |
Dr. Rohan Lalith Deraniyagala, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 18101 Oakwood Blvd, Dearborn, MI 48124 Phone: 248-551-5490 | |
Jerry W Drake, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 840 Oakwood Blvd, Dearborn, MI 48124 Phone: 313-359-7650 Fax: 313-359-7660 | |
Hassan Hamadi, DO Radiology Medicare: Medicare Enrolled Practice Location: 18101 Oakwood Blvd, Dearborn, MI 48124 Phone: 313-593-7000 | |
Joon K Kim, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 840 Oakwood Blvd, Dearborn, MI 48124 Phone: 313-359-7650 Fax: 313-359-7660 | |
Sophia M Roumanis, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 840 Oakwood Blvd, Dearborn, MI 48124 Phone: 313-359-7650 Fax: 313-359-7660 | |
Michael F Zydeck, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 840 Oakwood Blvd, Dearborn, MI 48124 Phone: 313-359-7650 Fax: 313-359-7660 |