Healthcare Provider Details

I. General information

NPI: 1134157803
Provider Name (Legal Business Name): MARIA A.K. LEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2785 CARL T JONES DR SE
HUNTSVILLE AL
35802-4946
US

IV. Provider business mailing address

510 S 4TH ST
GADSDEN AL
35901-5217
US

V. Phone/Fax

Practice location:
  • Phone: 256-964-9682
  • Fax:
Mailing address:
  • Phone: 256-543-1865
  • Fax: 256-546-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25920
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: