Organization
LEE K GOLD DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE KEVIN GOLD (OWNER)
(810) 227-4155
Entity
Organization
Contact information
Practice address
5889 WHITMORE LAKE RD STE A, BRIGHTON, MI 48116-1998
(810) 227-4155
(810) 227-0845
Mailing address
5889 WHITMORE LAKE RD, SUITE 1, BRIGHTON, MI 48116-1998
(810) 227-4155
(810) 227-0845
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
LG400121
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480D710370
BLUE CROSS BLUE SHIELD
MI
Enumeration date
06/15/2007
Last updated
01/23/2019
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