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NPI Code Detail

MEDICARE: COURTNEY LEE MD

MEDICARE: COURTNEY 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
1207Q00000XFamily Medicine PhysicianMT193885PA
2207Q00000XFamily Medicine Physician2013012533MO
3207Q00000XFamily Medicine PhysicianMD442860PA

General Provider Information

NPI Number : 1801058417
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY LEE MD
Provider Business Mailing Address
First Line : 5201 HAVERFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-1401
Country : US
Telephone Number : 215-471-2761
Fax Number : 215-472-6092
Provider Business Practice Location Address
First Line : 5201 HAVERFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-1401
Country : US
Telephone Number : 215-471-2761
Fax Number : 215-472-6092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2008
Last Update Date : 10/31/2017

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Directions to “ COURTNEY LEE MD” Practice Location

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