Provider Demographics
NPI:1538581673
Name:LEE M WEDEN, MARTHA (MS)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:LEE M WEDEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:ANN LEE
Other - Last Name:JEUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1390 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5402
Mailing Address - Country:US
Mailing Address - Phone:415-252-3938
Mailing Address - Fax:415-252-3910
Practice Address - Street 1:1390 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5402
Practice Address - Country:US
Practice Address - Phone:415-252-3938
Practice Address - Fax:415-252-3910
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist