Individual
LEE GARDIE JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 701-4502
(410) 521-7669
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-2465
(717) 741-3043
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD424930
PA
207RP1001X
Pulmonary Disease Physician
Primary
D56632
MD
207RP1001X
Pulmonary Disease Physician
MD424930
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101209096
—
PA
01
—
1542467
GATEWAY-WMG
PA
01
—
1671431
HIGHMARK BLUE SHIELD
PA
01
—
20087292
AMERIHEALTH MERCY-WMG
PA
01
—
271387
UNISON-WMG
PA
01
—
614218
CAREFIRST MD BCBS
MD
Enumeration date
08/23/2005
Last updated
03/09/2022
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