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General NPI Number Information
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NPI Number | 1043409782
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Entity Type | Organization
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Legal Business Name | WALTER J LEE MD PC
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 280 WASHINGTON ST SUITE 201
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City | BRIGHTON
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State | MA
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Zip | 02135-3511
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Country | US
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Telephone | 617-254-7473
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Fax | 617-254-3141
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Provider Business Mailing Address
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Address Line | 280 WASHINGTON ST SUITE 201
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City | BRIGHTON
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State | MA
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Zip | 02135-3511
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Country | US
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Telephone | 617-254-7473
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Fax | 617-254-3141
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Authorized Official
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Title or Position | OWNER
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Name | DR. WALTER J LEE
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Credential | MD
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Telephone | 617-254-7473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 50245
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License Number State | MA
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