Individual
GERALD LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
426 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-5609
(616) 267-7888
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301053671
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4199651
—
MI
Enumeration date
06/15/2005
Last updated
02/23/2021
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