Individual
THOMAS MARTIN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 PILGRIM BLVD, HARTFORD CITY, IN 47348-1382
(765) 348-5776
(765) 348-3088
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01030229A
IN
207Q00000X
Family Medicine Physician
01030229
IN
207Q00000X
Family Medicine Physician
Primary
01030229A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100059570
—
IN
01
—
P00049764
RR MEDICARE
IN
01
—
P00968556
RR MEDICARE
IN
Enumeration date
05/16/2006
Last updated
02/22/2021
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