Provider Demographics
NPI:1548286727
Name:HANG-FU, LEE C (MD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:C
Last Name:HANG-FU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21080 LORAIN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-2127
Mailing Address - Country:US
Mailing Address - Phone:440-333-9801
Mailing Address - Fax:440-333-4669
Practice Address - Street 1:21080 LORAIN RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-2127
Practice Address - Country:US
Practice Address - Phone:440-333-9801
Practice Address - Fax:440-333-4669
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-061505208200000X
MI4301049252208200000X
NJ25MA05329900208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0846679Medicaid
OHE53489Medicare UPIN
OHHA0713297Medicare ID - Type Unspecified