Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | D0033531 | MD |
N | 2080A0000X | Adolescent Medicine | D0033531 | MD |
NPI | 1043214810 |
---|---|
Provider Name | Dr. James Paul Lee |
First Address | New Market, MD 21774 |
Second Address | New Market, MD 21774 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 15/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
402541500 | (05) | MD |