Individual
DR. EVAN W. LEE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
645 E 5TH ST, WEISER, ID 83672-2202
(208) 549-0370
Mailing address
4500 W ESCALANTE DR, EAGLE, ID 83616-4470
(808) 651-8846
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DOS-997
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000242321
HMSA
HI
01
—
111156
UHA
HI
05
—
538332 01
—
HI
Enumeration date
11/17/2006
Last updated
08/26/2022
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