Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 19189 | TN |
N | 207RN0300X | Nephrologist | 31677 | KY |
NPI | 1073505830 |
---|---|
Provider Name | Stanley M. Lee |
First Address | Nashville, TN 37205-1499 |
Second Address | Nashville, TN 37205-1499 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 29/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3036579 | (05) | TN |
64793303 | (05) | KY |
C46965 | (02) | TN |