Individual
ANDREW JOHN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
385 N SELTZER ST, SUITE 3, CRESTLINE, OH 44827-1400
(419) 468-0449
(419) 468-0634
Mailing address
385 N SELTZER ST, SUITE3, CRESTLINE, OH 44827-1400
(419) 468-0449
(419) 468-0634
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.068404
OH
207R00000X
Internal Medicine Physician
68404
OH
208000000X
Pediatrics Physician
35.068404
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159135
—
OH
Enumeration date
12/28/2005
Last updated
01/07/2021
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