MEDICARE: CHRISTOPHER LEE MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	390200000X	Student in an Organized Health Care Education/Training Program	260761	MA
3	208200000X	Plastic Surgery Physician	291272	MA

General Provider Information

NPI Number	:	1508270281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER LEE MD

Provider Business Mailing Address
First Line	:	25 BOYLSTON ST STE 304
Second Line	:
City	:	CHESTNUT HILL
State	:	MA
Zip	:	02467-1710
Country	:	US
Telephone Number	:	617-505-6818
Fax Number	:	617-505-6813

Provider Business Practice Location Address
First Line	:	25 BOYLSTON ST STE 304
Second Line	:
City	:	CHESTNUT HILL
State	:	MA
Zip	:	02467-1710
Country	:	US
Telephone Number	:	617-505-6818
Fax Number	:	617-505-6813

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

Provider Enumeration Date	:	06/20/2014
Last Update Date	:	08/09/2022

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