Individual
VIVIAN Y LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-6415
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 442-3168
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2007-0594
NM
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
9148220-1205
UT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD2007-0594
NM
207RP1001X
Pulmonary Disease Physician
Primary
9148220-1205
UT
207RP1001X
Pulmonary Disease Physician
MD2007-0594
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202024178
PRESBYTERIAN HEALTH PLANS
—
05
—
43724086
—
NM
01
—
NM001R76
BCBS NM
NM
01
—
QMP000003399128
MOLINA
—
Enumeration date
07/21/2006
Last updated
12/04/2014
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