Individual
NEVADA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
6317 EVANSTON AVE, RAYTOWN, MO 64133-4929
(816) 353-3939
(816) 353-2688
Mailing address
6317 EVANSTON AVE, RAYTOWN, MO 64133-4929
(816) 353-3939
(816) 353-2688
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
R6C78
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005073A
MEDICARE
MO
Enumeration date
10/23/2006
Last updated
07/17/2008
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