| Mary Lee Md, Pc | |
|
33200 W 14 Mile Rd West Bloomfield MI 48322-3563 | |
| (248) 419-5111 | |
| Not Available |
| Full Name | Mary Lee Md, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 33200 W 14 Mile Rd, West Bloomfield, Michigan |
| Authorized Official Name and Position | Mary S Lee (PHYSICIAN) |
| Authorized Official Contact | 2484195111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Lee Md, Pc 33200 W 14 Mile Rd West Bloomfield MI 48322-3563 Ph: (248) 419-5111 | Mary Lee Md, Pc 33200 W 14 Mile Rd West Bloomfield MI 48322-3563 Ph: (248) 419-5111 |
| NPI Number | 1598296485 |
|---|---|
| Provider Enumeration Date | 03/23/2017 |
| Last Update Date | 03/23/2017 |
| Medicare PECOS PAC ID | 5496022097 |
|---|---|
| Medicare Enrollment ID | O20170602001197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598296485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 43010161252 (Michigan) | Primary |
| Provider Name | Mary S Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932180817 PECOS PAC ID: 9739276544 Enrollment ID: I20071025000600 |
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