Individual
MR. KEVIN T. LIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3225 CUMBERLAND BLVD SE STE 520, ATLANTA, GA 30339-6407
(678) 915-2000
(404) 868-3363
Mailing address
3225 CUMBERLAND BLVD SE STE 520, ATLANTA, GA 30339-6407
(678) 915-2000
(404) 868-3363
Taxonomy
Speciality
Code
Description
License number
State
207UN0901X
Nuclear Cardiology Physician
35090995
OH
207UN0902X
Nuclear Imaging & Therapy Physician
35090995
OH
207UN0903X
In Vivo & In Vitro Nuclear Medicine Physician
35090995
OH
2085B0100X
Body Imaging Physician
35090995
OH
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
35090995
OH
2085H0002X
Hospice and Palliative Medicine (Radiology) Physician
35090995
OH
2085N0700X
Neuroradiology Physician
35090995
OH
2085N0904X
Nuclear Radiology Physician
35090995
OH
2085P0229X
Pediatric Radiology Physician
35090995
OH
2085R0001X
Radiation Oncology Physician
35090995
OH
2085R0202X
Diagnostic Radiology Physician
35090995
OH
2085R0203X
Therapeutic Radiology Physician
35090995
OH
2085R0204X
Vascular & Interventional Radiology Physician
35090995
OH
2085R0204X
Vascular & Interventional Radiology Physician
Primary
81456
GA
2085R0204X
Vascular & Interventional Radiology Physician
GA81456
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003250880L
—
GA
05
—
1025726440001
—
PA
01
—
204881619259
CARESOURCE
OH
05
—
2788381
—
OH
01
—
465114
WELLCARE
OH
01
—
P00648554
RAILROAD MEDICARE
OH
Enumeration date
07/12/2007
Last updated
04/23/2025
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