Provider Demographics
NPI:1013185594
Name:LEE, AMANDA SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:SUE
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 CHILDREN DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6791
Mailing Address - Country:US
Mailing Address - Phone:513-336-6700
Mailing Address - Fax:
Practice Address - Street 1:9600 CHILDREN DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6791
Practice Address - Country:US
Practice Address - Phone:513-336-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35093104208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics