MEDICARE: SHIN W LEE MD

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	207L00000X	Anesthesiology Physician	9475	NV

General Provider Information

NPI Number	:	1548246598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIN W LEE MD

Provider Business Mailing Address
First Line	:	2635 BOX CANYON DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0450
Country	:	US
Telephone Number	:	702-386-4700
Fax Number	:	702-386-4701

Provider Business Practice Location Address
First Line	:	2635 BOX CANYON DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0450
Country	:	US
Telephone Number	:	702-386-4700
Fax Number	:	702-386-4701

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

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	07/08/2007

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Directions to “ SHIN W LEE MD” Practice Location

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