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Individual

LEE BRIAN PADOVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
980 JOHNSON FERRY RD, SUITE 520, ATLANTA, GA 30342-1626
(404) 303-3320
(404) 303-3464
Mailing address
980 JOHNSON FERRY RD, SUITE 520, ATLANTA, GA 30342-1626
(404) 303-3320
(404) 303-3464

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
029748
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000652253D
GA
05
000652253E
GA
05
00652253B
GA
01
060043786
MCR RR
GA
01
578910
BCBS
Enumeration date
01/13/2006
Last updated
10/12/2020
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