Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 207397 | MA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | D86533 | MD |
N | 2081P2900X | Pain Medicine | 207397 | MA |
Y | 2081P2900X | Pain Medicine | D86533 | MD |
NPI | 1275591364 |
---|---|
Provider Name | James J Lee |
First Address | Columbia, MD 21044-3631 |
Second Address | Columbia, MD 21044-3631 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 05/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0113191 | (05) | MA |
207397 | TUFTS HEALTH PLAN (01) | MA |
AA36624 | HARVARD PILGRIM HEALTHCAR (01) | MA |
H16376 | (02) | MA |
J22437 | BLUE CROSS/BLUE SHIELD (01) | MA |