Healthcare Provider Details

I. General information

NPI: 1740390160
Provider Name (Legal Business Name): LEE H COLONY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 HANNAH BLVD SUITE 110
EAST LANSING MI
48823-5384
US

IV. Provider business mailing address

1701 LAKE LANSING RD SUITE 100
LANSING MI
48912-3798
US

V. Phone/Fax

Practice location:
  • Phone: 517-333-4960
  • Fax:
Mailing address:
  • Phone: 517-485-0001
  • Fax: 517-485-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LEE H COLONY
Title or Position: OWNER
Credential: MD
Phone: 517-333-4960