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General NPI Number Information
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NPI Number | 1760320576
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Entity Type | Individual
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Provider Name | LEE MAYBERRY DO
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Gender | Female
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 800 GARFIELD AVE
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City | PARKERSBURG
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State | WV
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Zip | 26101-5376
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Country | US
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Telephone | 304-424-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 11605 HURON CT SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-3489
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Country | US
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Telephone | 505-582-8002
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | WV
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