Provider Demographics
NPI:1902908411
Name:LEE, WOODROW DAVIS (DO)
Entity type:Individual
Prefix:DR
First Name:WOODROW
Middle Name:DAVIS
Last Name:LEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:57 BARRA RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9446
Mailing Address - Country:US
Mailing Address - Phone:207-286-3504
Mailing Address - Fax:207-286-3767
Practice Address - Street 1:57 BARRA RD
Practice Address - Street 2:SUITE #1
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9448
Practice Address - Country:US
Practice Address - Phone:207-286-3504
Practice Address - Fax:207-286-3767
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2008-08-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME1494207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME2733011OtherAETNA
MEF92028OtherHARVARD PILGRIM
ME314300099Medicaid
ME041481OtherANTHEM
MEF92028Medicare UPIN
MEF92028OtherHARVARD PILGRIM
ME041481OtherANTHEM