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Individual

DR. LEE KEVIN GOLD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
5889 WHITMORE LAKE RD, SUITE 1, BRIGHTON, MI 48116-1998
(810) 227-4155
(810) 227-0845
Mailing address
6647 BRISTOL DR, WEST BLOOMFIELD, MI 48322-3263
(248) 661-1974

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
5401400121
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
LG400121
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3113590
MI
01
4894750020
BCBS NUMBER
MI
Enumeration date
11/03/2006
Last updated
04/23/2012
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