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Individual

ANDY LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1850 STATE ST, NEW ALBANY, IN 47150-4990
(502) 625-5584
Mailing address
320 WHITTINGTON PKWY, SUITE 301, LOUISVILLE, KY 40222-4928
(502) 625-5584
(502) 426-2264

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01066793A
IN
207L00000X
Anesthesiology Physician
57010099
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000622689
ANTHEM
IN
01
106117
SIHO
IN
01
129703800
US DEPT. OF LABOR
IN
05
200948500
IN
01
3722991000
PASSPORT ADVANTAGE
01
50024466
PASSPORT
05
7100104020
KY
Enumeration date
05/25/2007
Last updated
05/12/2016
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