Michael David Lee M.D.

NPI 1013114933 - Family Medicine - 207Q00000X

NPI Details
NPI 1013114933
Gender Male
Enumeration Date 07/03/2007
Last Updated 03/10/2011
Entity Type Individual
Active Over 9 years ago
Practice Location
1512 N GREEN MOUNT RD
SUITE 200
O FALLON IL, 62269-1953, US
Phone (618) 624-1860
Fax (618) 624-1863
Business Location
1512 N GREEN MOUNT RD
SUITE 200
O FALLON IL, 62269-1953, US
Phone (618) 624-1860
Fax (618) 624-1863
Toxanomy
Taxonomy Code 207Q00000X
License State Illinois
License Number 036.126487
Remove 1013114933 NPI Number
 

According to our database, Dr. Michael David Lee M.D. NPI is 1013114933, taxonomy code is 207Q00000X and license number is 036.126487, license state is located at Illinois. Michael David Lee M.D. physically located at 1512 N Green Mount Rd, O Fallon IL, 62269-1953. NPI Number Michael David Lee M.D. has the Individual type.

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1013114933 NPI number is provided on an as is basis without warranty of any kind. 1013114933 is maintained by the National Plan & Provider Enumeration System. The contents of Michael David Lee M.D. are for informational purposes only.