Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 35082667 | OH |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 2008-00658 | NC |
NPI | 1821052994 |
---|---|
Provider Name | Walter T Lee |
First Address | Durham, NC 27704-2121 |
Second Address | Durham, NC 27710-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 25/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2565942 | (05) | OH |
5909225 | (05) | NC |
I29706 | (02) | OH |