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NPI Code Detail

MEDICARE: DR. STEVEN BRENT LEE M.D.

MEDICARE: DR. STEVEN BRENT LEE M.D.
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 Physician344326-1205UT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00199633OTHERUTRR MEDICARE
3P00651543OTHERUTRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629075684
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN BRENT LEE M.D.
Provider Business Mailing Address
First Line : PO BOX 25488
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84125-0488
Country : US
Telephone Number : 800-475-3698
Fax Number : 801-296-6199
Provider Business Practice Location Address
First Line : 1433 N 1075 W STE 104
Second Line :
City : FARMINGTON
State : UT
Zip : 84025-2746
Country : US
Telephone Number : 801-298-1300
Fax Number : 801-296-6199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2005
Last Update Date : 09/13/2021

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Directions to “ DR. STEVEN BRENT LEE M.D.” Practice Location

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