Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 57.026618 | OH |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD472950 | PA |
N | 207YP0228X | Pediatric Otolaryngology | MT221150 | PA |
NPI | 1679968820 |
---|---|
Provider Name | Dr. David Raleigh Lee |
First Address | Philadelphia, PA 19104-4222 |
Second Address | Philadelphia, PA 19104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2015 |
Last Update Date | 19/04/2021 |