Provider Demographics
NPI:1063424935
Name:LEE, LAWRENCE I (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:I
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:120 CAHABA VALLEY PKWY
Mailing Address - Street 2:SUITE203
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1185
Mailing Address - Country:US
Mailing Address - Phone:205-985-9828
Mailing Address - Fax:205-985-9975
Practice Address - Street 1:120 CAHABA VALLEY PKWY
Practice Address - Street 2:SUITE203
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1185
Practice Address - Country:US
Practice Address - Phone:205-985-9828
Practice Address - Fax:205-985-9975
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2011-05-03
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Provider Licenses
StateLicense IDTaxonomies
AL20235207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G45618Medicare UPIN