Individual
DR. MODESTUS LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
038874
CT
2080N0001X
Neonatal-Perinatal Medicine Physician
038874
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50GREENEOCT01
ANTHEM
CT
01
—
P1126523
OXFORD
—
Enumeration date
07/27/2006
Last updated
09/11/2025
Update your record
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