Individual
LEE H COLONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 HANNAH BLVD, SUITE 110, EAST LANSING, MI 48823-5384
(517) 333-4960
Mailing address
1701 LAKE LANSING RD, SUITE 100, LANSING, MI 48912-3798
(517) 485-0001
(517) 485-1138
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
LC047732
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13-00009
PHP
MI
01
—
200000001140
PHPMM
MI
01
—
2403310722
BLUE CROSS BLUE SHIELD
MI
05
—
3160090
—
MI
Enumeration date
06/02/2006
Last updated
09/07/2007
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