Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2448 | AK |
N | 207QS0010X | Family Doctor - Sports Medicine | 2448 | AK |
NPI | 1235169509 |
---|---|
Provider Name | Cindy M Lee |
First Address | Anchorage, AK 99508 |
Second Address | Anchorage, AK 99508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 14/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E84790 | (02) | AK |
MD0105 | (05) | AK |