MEDICARE: DR. STEPHEN ALEXANDER LEE DO

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
1	207P00000X	Emergency Medicine Physician	OT020980	PA

General Provider Information

NPI Number	:	1396370581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN ALEXANDER LEE DO

Provider Business Mailing Address
First Line	:	1345 MARTIN CT APT 721
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-2577
Country	:	US
Telephone Number	:	949-910-2989
Fax Number	:

Provider Business Practice Location Address
First Line	:	3127 UMATILLA ST APT 2
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5638
Country	:	US
Telephone Number	:	949-910-2989
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2020
Last Update Date	:	06/16/2021

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