Wine Lee, Lara

Wine Lee, Lara is an individual health care provider with primary practice located at 171 Ashley Ave , Charleston SC 29425-8908. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Pediatric Dermatology. Allopathic & Osteopathic Physicians / Pediatric Dermatology is her primary health care specialty. Wine Lee, Lara can be contacted via phone (843) 792-1414.

Contact Information

Primary practice address
171 Ashley Ave Charleston SC 29425-8908
Phone: (843) 792-1414
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MT190407 Pennsylvania
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 37328 South Carolina
Allopathic & Osteopathic Physicians / Pediatric Dermatology 207NP0225X 37328 South Carolina

Profile Details

NPI number 1710187224
LBN Legal business name Wine Lee, Lara
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 23rd, 2007
Last updated Oct 22nd, 2020 - about 5 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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