| Mary A Lee Md Inc | |
|
6746 Dick Flynn Blvd Goshen OH 45122-8609 | |
| (513) 722-2603 | |
| (513) 722-3423 |
| Full Name | Mary A Lee Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6746 Dick Flynn Blvd, Goshen, Ohio |
| Authorized Official Name and Position | Mary A Lee (PRESIDENT) |
| Authorized Official Contact | 5137222603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary A Lee Md Inc 6746 Dick Flynn Blvd Goshen OH 45122-8609 Ph: (513) 722-2603 | Mary A Lee Md Inc 6746 Dick Flynn Blvd Goshen OH 45122-8609 Ph: (513) 722-2603 |
| NPI Number | 1043373517 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 08/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043373517 | NPI | - | NPPES |
| 0344041 | Medicaid | OH | |
| P00608181 | Other | OH | MEDICARE RR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35041350 (Ohio) | Primary |
Healthsource: Goshen Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6694 Goshen Rd Ste 324, Goshen, OH 45122 Phone: 513-592-3690 Fax: 513-592-3708 | |
Healthsource Goshen Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6694 Goshen Rd Ste 324, Goshen, OH 45122 Phone: 513-592-3690 Fax: 513-923-3708 |