Individual
DR. JOHN D LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3241
(765) 281-6567
Mailing address
221 N CELIA AVE, MUNCIE, IN 47303-4609
(765) 747-3141
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01042782A
IN
207Q00000X
Family Medicine Physician
01042782A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082495
ANTHEM BC/BS
IN
01
—
000000626429
ANTHEM BC/BS
IN
01
—
000000658190
ANTHEM BC/BS
IN
05
—
100380770
—
IN
Enumeration date
06/09/2006
Last updated
04/06/2022
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