Provider Demographics
NPI:1902918527
Name:LEE, HEIDI H (MD)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:H
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8424 NAAB RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5918
Mailing Address - Country:US
Mailing Address - Phone:317-614-3100
Mailing Address - Fax:317-614-3111
Practice Address - Street 1:8424 NAAB RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5918
Practice Address - Country:US
Practice Address - Phone:317-614-3100
Practice Address - Fax:317-614-3111
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01044084AB2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INBL7613791OtherDEA NUMBER
IN189950AMedicare ID - Type UnspecifiedMEDICARE NUMBER
ING71499Medicare UPIN