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NPI Code Detail

MEDICARE: ESTHER LEE D.O.

MEDICARE: ESTHER LEE D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianH0078797MD
22085R0202XDiagnostic Radiology PhysicianR8595TX
32085R0202XDiagnostic Radiology Physician34.014833OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063640878
Entity Type Code : Individual
Provider Name (Legal Business Name) : ESTHER LEE D.O.
Provider Business Mailing Address
First Line : 10373A REISTERSTOWN ROAD
Second Line : ATTN: CREDENTIALING DEPARTMENT
City : OWINGS MILLS
State : MD
Zip : 21117-3617
Country : US
Telephone Number : 443-548-7595
Fax Number : 410-356-4180
Provider Business Practice Location Address
First Line : 8201 E RIVERSIDE BLVD
Second Line :
City : ROCKFORD
State : IL
Zip : 61114-2300
Country : US
Telephone Number : 815-971-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2009
Last Update Date : 12/18/2025

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