Individual
SAMUEL KYLE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 744-4757
(252) 744-5014
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2017-02058
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184044596
—
NC
01
—
19SQ9
BCBS OF NC
NC
01
—
NCZ538A
MEDICARE
NC
Enumeration date
04/24/2014
Last updated
02/19/2024
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