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General NPI Number Information
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NPI Number | 1922015973
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Entity Type | Individual
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Provider Name | MICHELE YEETING LEE MD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 350 PONCA PL SUITE 250
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City | BOULDER
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State | CO
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Zip | 80303-3828
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Country | US
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Telephone | 303-938-1110
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Fax | 303-938-1145
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Provider Business Mailing Address
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Address Line | 350 PONCA PL SUITE 250
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City | BOULDER
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State | CO
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Zip | 80303-3828
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Country | US
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Telephone | 303-938-1110
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Fax | 303-938-1145
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 99-243
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | DR-47318
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License Number State | CO
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