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General NPI Number Information
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NPI Number | 1114911005
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Entity Type | Individual
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Provider Name | MICHAEL WILLIAM DEE MD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 05/05/2016
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Provider Practice Location Address
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Address Line | 3950 KRESGE WAY SUITE 104
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City | LOUISVILLE
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State | KY
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Zip | 40207-4637
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Country | US
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Telephone | 502-896-8028
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Fax | 502-896-7152
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Provider Business Mailing Address
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Address Line | PO BOX 950248
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City | LOUISVILLE
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State | KY
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Zip | 40295-0248
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Country | US
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Telephone | 502-253-4900
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Fax | 502-489-5750
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 21961
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License Number State | KY
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