Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | D0023601 | MD |
NPI | 1043285190 |
---|---|
Provider Name | Dr. Edward James Lee |
First Address | Columbia, MD 21044-3128 |
Second Address | Columbia, MD 21044-3128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 11/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
156621100 | (05) | MD |
E10893 | (02) |