Organization
MARY A LEE MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY A LEE MD (PRESIDENT)
(513) 722-2603
Entity
Organization
Contact information
Practice address
6746 DICK FLYNN BLVD, GOSHEN, OH 45122-8609
(513) 722-2603
(513) 722-3423
Mailing address
6746 DICK FLYNN BLVD, GOSHEN, OH 45122-8609
(513) 722-2603
(513) 722-3423
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35041350
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0344041
—
OH
01
—
P00608181
MEDICARE RR
OH
Enumeration date
12/18/2006
Last updated
08/29/2011
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