Healthcare Provider Details

I. General information

NPI: 1467036715
Provider Name (Legal Business Name): KAMARIA LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 LINDEN AVE NE
ATLANTA GA
30308-2951
US

IV. Provider business mailing address

36 LINDEN AVE NE
ATLANTA GA
30308-2951
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-1900
  • Fax:
Mailing address:
  • Phone: 404-778-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number111082
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: