Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | D0068714 | MD |
NPI | 1013183243 |
---|---|
Provider Name | Dr. Patrick L Lee |
First Address | Fulton, MD 20759-2662 |
Second Address | Fulton, MD 20759-2662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2008 |
Last Update Date | 12/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
417085700 | (05) | MD |
D0068714 | MARYLAND LICENSE (01) | MD |