Individual
MR. MATTHEW D LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
9 RICHLAND MEDICAL PARK DR STE 505, COLUMBIA, SC 29203-6844
(803) 434-2505
(803) 434-2181
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1368
TN
363A00000X
Physician Assistant
Primary
2350
SC
363A00000X
Physician Assistant
PA9105544
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2277PA
—
SC
Enumeration date
06/28/2006
Last updated
04/28/2021
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