MEDICARE: DR. STEPHEN 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
1	207P00000X	Emergency Medicine Physician	MD.41208	AL
2	390200000X	Student in an Organized Health Care Education/Training Program		TN
3	207Q00000X	Family Medicine Physician	MD.41208	AL

General Provider Information

NPI Number	:	1669907325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN LEE M.D.

Provider Business Mailing Address
First Line	:	5210 THORNCREEK CT
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95135-1224
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 DR. D B TODD JR. BLVD.
Second Line	:	OLD HOSP. BLDG., 3RD FLOOR
City	:	NASHVILLE
State	:	TN
Zip	:	37208-1224
Country	:	US
Telephone Number	:	615-327-6168
Fax Number	:

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

Provider Enumeration Date	:	05/01/2017
Last Update Date	:	07/27/2020

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