Individual
MATTHEW R LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 WEST FOURTH STREET, SUITE 4, MOUNT VERNON, IN 47620
(812) 838-4891
(812) 838-6595
Mailing address
PO BOX 717, MOUNT VERNON, IN 47620-0717
(812) 838-4891
(812) 838-6595
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01032902
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000043063
BCBS
IN
05
—
100210240A
—
IN
Enumeration date
06/20/2006
Last updated
02/25/2010
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