Healthcare Provider Details
I. General information
NPI: 1639340136
Provider Name (Legal Business Name): ADRIENNE WAI-WAH LEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/12/2008
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8501 OLD TROY PIKE STE 120
HUBER HEIGHTS OH
45424-1061
US
IV. Provider business mailing address
PO BOX 933432
CLEVELAND OH
44193-0039
US
V. Phone/Fax
- Phone: 937-237-4945
- Fax: 937-237-4925
- Phone: 937-641-3000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD440300 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 35.120351 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: