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Individual
JOHN MARTIN LEE JR.
Active
Individual
JOHN MARTIN LEE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
10710
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010520
—
MS
05
—
009002820
—
AL
01
—
0114538
BLUE CROSS BLUE SHIELD MS
MS
01
—
10710
STATE LIC NUMBER
MS
01
—
73012088
BLUE CROSS BLUE SHIELD/ OTHER STATES
—
Enumeration date
01/24/2006
Last updated
06/30/2008
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