Provider Demographics
NPI:1154433795
Name:LEE, STEPHEN L (MD,PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:L
Last Name:LEE
Suffix:
Gender:M
Credentials:MD,PHD
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Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC, DEPARTMENT OF NEUROLOGY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-5104
Mailing Address - Fax:603-650-6233
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC, DEPARTMENT OF MEDICINE SECTION OF NEUROLOGY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-5104
Practice Address - Fax:603-650-6233
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH125622084N0400X, 2084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30204670Medicaid
VT1010895Medicaid
NH30204670Medicaid
VT1010895Medicaid