Organization
MICHEAL T LEE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T LEE M.D. (MEDICAL DOCTOR)
(602) 667-6640
Entity
Organization
Contact information
Practice address
2222 E HIGHLAND AVE, SUITE 425, PHOENIX, AZ 85016-4872
(602) 667-6640
(602) 667-3305
Mailing address
2222 E HIGHLAND AVE, SUITE 425, PHOENIX, AZ 85016-4872
(602) 667-6640
(602) 667-3305
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
22408
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1758293
—
AZ
01
—
4193000
CIGNA
AZ
01
—
AZ0830720
BLUE CROSS BLUE SHIELD
AZ
05
—
POR13LEE9MI1
—
AZ
Enumeration date
10/15/2013
Last updated
10/15/2013
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