Individual
MADELINE ANDERSON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
912 OLD GEORGETOWN ROAD, MT. PLEASANT, SC 29464
(843) 216-3530
Mailing address
1215 SPRINGHILL RD, HANAHAN, SC 29410-2027
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4155
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4155
SC LICENSE
SC
Enumeration date
02/12/2022
Last updated
04/01/2024
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