Provider Demographics
NPI:1457143372
Name:LEE, MAURICE
Entity type:Individual
Prefix:PROF
First Name:MAURICE
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 WINDFLOWER WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4288
Mailing Address - Country:US
Mailing Address - Phone:240-462-7035
Mailing Address - Fax:240-462-7035
Practice Address - Street 1:3708 YOSEMITE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7107
Practice Address - Country:US
Practice Address - Phone:240-462-7035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging