Individual
MATTHEW LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 ANNE ST NW, BEMIDJI, MN 56601-5103
(218) 333-5283
Mailing address
PO BOX 2010, FARGO, ND 58122-2484
(218) 333-5283
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
52683
MN
2085R0202X
Diagnostic Radiology Physician
MD00048784
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780628149
—
MN
Enumeration date
07/22/2009
Last updated
07/21/2022
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