Healthcare Provider Details

I. General information

NPI: 1972730224
Provider Name (Legal Business Name): AMY LEE HARRIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY MICHELLE LEE

II. Dates (important events)

Enumeration Date: 06/14/2009
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 BRIARGATE PKWY UNIT 350
COLORADO SPRINGS CO
80920-7851
US

IV. Provider business mailing address

9600 BLACKWELL RD STE 500
ROCKVILLE MD
20850-3783
US

V. Phone/Fax

Practice location:
  • Phone: 719-314-3333
  • Fax: 719-314-3344
Mailing address:
  • Phone: 301-340-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number263154
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberDR.0067492
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: