Individual
NATHANIEL A LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8936 SOUTHPOINTE DR STE B4, INDIANAPOLIS, IN 46227-7506
(317) 621-0668
Mailing address
2200 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2312
(310) 449-5291
(310) 582-7185
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
01086218A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300052400
—
IN
Enumeration date
05/30/2012
Last updated
08/04/2021
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