Individual
KEITH LEE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7602 BELAIR RD, BALTIMORE, MD 21236-4088
(410) 663-8100
(410) 663-8119
Mailing address
PO BOX 62026, BALTIMORE, MD 21264-2026
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0055587
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KF68 / 607945-03
BC / BS OF MD
MD
01
—
S190 / 0085
BLUECHOICE
MD
Enumeration date
06/07/2006
Last updated
07/08/2007
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