Individual
DR. IVY M LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
514 W 2ND ST, BLOOMINGTON, IN 47403-2316
(812) 353-3719
(812) 353-3713
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
01049528A
IN
207V00000X
Obstetrics & Gynecology Physician
01049528
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200203160
—
IN
Enumeration date
07/03/2006
Last updated
12/03/2020
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