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General NPI Number Information
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NPI Number | 1467681619
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Entity Type | Individual
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Provider Name | BRIAN LEE D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 30 W COLE RD
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City | BIDDEFORD
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State | ME
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Zip | 04005-9453
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Country | US
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Telephone | 207-284-6673
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Fax | 207-294-7365
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Provider Business Mailing Address
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Address Line | 30 W COLE RD
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City | BIDDEFORD
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State | ME
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Zip | 04005-9453
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Country | US
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Telephone | 207-284-6673
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Fax | 207-294-7365
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | DO2863
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License Number State | ME
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