Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD.34468 | AL |
NPI | 1013329267 |
---|---|
Provider Name | Eric Lee |
First Address | Vestavia, AL 35243-2372 |
Second Address | Charleston, SC 29425-8900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2014 |
Last Update Date | 05/11/2018 |