Individual
DR. MARK ROBERT LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 MEDICAL PARK STE 508, WHEELING, WV 26003
(304) 243-8916
(304) 243-7194
Mailing address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(210) 704-4100
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
039151
GA
207T00000X
Neurological Surgery Physician
27496
SC
207T00000X
Neurological Surgery Physician
28512
WV
207T00000X
Neurological Surgery Physician
Primary
N2167
TX
2086S0120X
Pediatric Surgery Physician
N2167
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000618032E
—
GA
01
—
GRP8134
MEDICARE GROUP#
GA
Enumeration date
07/21/2006
Last updated
02/09/2022
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