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General NPI Number Information
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NPI Number | 1669856894
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Entity Type | Individual
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Provider Name | BRIAN LEE DPM
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Gender | Male
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1325 SATELLITE BLVD NW STE 701A
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City | SUWANEE
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State | GA
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Zip | 30024-4676
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Country | US
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Telephone | 770-765-1237
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Fax | 707-880-3219
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Provider Business Mailing Address
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Address Line | 4191 BAVERTON DR
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City | SUWANEE
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State | GA
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Zip | 30024-8725
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Country | US
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Telephone | 770-765-1237
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Fax | 707-880-3219
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD001533
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License Number State | GA
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