Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 35692 | NC |
Y | 207RP1001X | Pulmonary Disease | 35692 | NC |
N | 207RS0012X | Sleep Medicine | 35692 | NC |
NPI | 1053339267 |
---|---|
Provider Name | Dr. Mitchell D Lee |
First Address | Wilmington, NC 28401-7307 |
Second Address | Wilmington, NC 28401-7307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 24/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110172644 | RAILROAD MEDICARE (01) | NC |
51532 | BCBS NC (01) | NC |
8951433 | (05) | NC |
F47638 | (02) | NC |