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Individual

MICHAEL LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790-2107
(607) 763-6000
Mailing address
6896 W SNOWVILLE RD, BRECKSVILLE, OH 44141-3214

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
206099
NY
207P00000X
Emergency Medicine Physician
MD421003
PA
207P00000X
Emergency Medicine Physician
ME77184
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
256928100
FL
01
44845
BLUE CROSS BLUE SHIELD
FL
01
5978691
AETNA
FL
Enumeration date
05/20/2006
Last updated
04/13/2022
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