Healthcare Provider Details

I. General information

NPI: 1023270600
Provider Name (Legal Business Name): KAMERYN JANELLE LEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12308 OCEAN GTWY STE 8
OCEAN CITY MD
21842-9341
US

IV. Provider business mailing address

3204 POINTS REACH
OCEAN PINES MD
21811-4210
US

V. Phone/Fax

Practice location:
  • Phone: 443-728-1050
  • Fax: 443-728-1051
Mailing address:
  • Phone: 443-924-0596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC1-0012607
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberD0069570
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: