Provider Demographics
NPI:1154439081
Name:LEE, SHARON D (MD)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:D
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5407 JOHNSON DR.
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205
Mailing Address - Country:US
Mailing Address - Phone:913-362-0220
Mailing Address - Fax:913-362-0440
Practice Address - Street 1:5407 JOHNSON DR.
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66205
Practice Address - Country:US
Practice Address - Phone:913-362-0220
Practice Address - Fax:913-362-0440
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4020303207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100205360AMedicaid
C50478Medicare UPIN