MEDICARE: STANTON 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	40492	IA

General Provider Information

NPI Number	:	1861669400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANTON LEE MD

Provider Business Mailing Address
First Line	:	3436 MAGAZINE ST
Second Line	:	# 310
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-2413
Country	:	US
Telephone Number	:	504-264-2515
Fax Number	:

Provider Business Practice Location Address
First Line	:	3436 MAGAZINE ST
Second Line	:	# 310
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-2413
Country	:	US
Telephone Number	:	504-264-2515
Fax Number	:

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

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	02/06/2016

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Directions to “ STANTON LEE MD” Practice Location

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