Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 036-114197 | IL |
N | 207V00000X | Obstetrician & Gynecologist | 40335 | AZ |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 40335 | AZ |
NPI | 1124131248 |
---|---|
Provider Name | Dr. Maureen Lee |
First Address | Gilbert, AZ 85297-7322 |
Second Address | Gilbert, AZ 85297-7322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 20/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40335 | MEDICAL LICENSE (01) | AZ |