MEDICARE: PATRICK SHEAN-YOUNG LEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	D0102987	MD
2	207W00000X	Ophthalmology Physician	4301517607	MI

General Provider Information

NPI Number	:	1326627530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK SHEAN-YOUNG LEE

Provider Business Mailing Address
First Line	:	400 MACK AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-2136
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4717 SAINT ANTOINE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-1423
Country	:	US
Telephone Number	:	313-577-8900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2021
Last Update Date	:	06/10/2026

Similar Medicare Providers

1477488260 — BRITTANY HODGES
Practice Location Address:

4717 SAINT ANTOINE ST
DETROIT, MI
48201-1423

Practice Phone: 313-577-8900
Practice Fax:

1811576291 — SANAH ASLAM MD
Practice Location Address:

4717 SAINT ANTOINE ST
DETROIT, MI
48201-1423

Practice Phone: 313-577-8900
Practice Fax:

1932190782 — DR. MASAO ROY WILSON M.D.
Practice Location Address:

4717 SAINT ANTOINE ST
DETROIT, MI
48201-1423

Practice Phone: 313-577-8900
Practice Fax:

1932185089 — DR. EVAN H BLACK MD
Practice Location Address:

4717 ST. ANTOINE , KRESGE EYE INSTITUTE
DETROIT, MI
48201-1423

Practice Phone: 313-577-8900
Practice Fax: 313-577-0700

1053388074 — WILLIAM ROBERT LUCAS JR. MD
Practice Location Address:

4717 SAINT ANTOINE ST , KRESGE EYE INSTITUTE
DETROIT, MI
48201-1423

Practice Phone: 313-577-8900
Practice Fax: 313-577-0700

1912950692 — MS. RUTH BOYMAN MD
Practice Location Address:

4717 SAINT ANTOINE ST
DETROIT, MI
48201-1423

Practice Phone: 313-577-8900
Practice Fax: 313-577-0700

Directions to “ PATRICK SHEAN-YOUNG LEE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.