Individual
DAVID J LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2325 18TH ST STE 220, COLUMBUS, IN 47201-5389
(812) 376-5640
(812) 376-5641
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01053942A
IN
208600000X
Surgery Physician
Primary
01053942A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200330190A
—
IN
Enumeration date
08/19/2006
Last updated
09/09/2024
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