Organization
LEE MARSHALL DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE BRUCE MARSHALL DO (PHYSICIAN NEUROLOGIST PRESIDENT)
(248) 208-9411
Entity
Organization
Contact information
Practice address
29829 TELEGRAPH RD, SUITE 202, SOUTHFIELD, MI 48034-1330
(248) 208-9411
(248) 208-9417
Mailing address
29829 TELEGRAPH RD, SUITE 202, SOUTHFIELD, MI 48034-1330
(248) 208-9411
(248) 208-9417
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
LM010950
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114567651
—
MI
01
—
1356310544
BCBS
MI
01
—
P00141408
PALMETTO
MI
Enumeration date
12/28/2006
Last updated
09/10/2009
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