Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD26132 | OR |
N | 111NI0900X | Internist | MD26132 | OR |
Y | 207RP1001X | Pulmonary Disease | MD26132 | OR |
NPI | 1003882622 |
---|---|
Provider Name | Dr. Marykay Lehman |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Grand Rapids, MI 49546-8292 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 23/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023273 | (05) | OR |
I41022 | (02) |