Provider Demographics
NPI:1023010998
Name:MCATEE, JINA LEE (MD)
Entity Type:Individual
Prefix:MRS
First Name:JINA
Middle Name:LEE
Last Name:MCATEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JINA
Other - Middle Name:AGNES
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:401 HOLLY HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63111-2410
Mailing Address - Country:US
Mailing Address - Phone:314-353-5190
Mailing Address - Fax:314-353-1310
Practice Address - Street 1:401 HOLLY HILLS AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63111-2410
Practice Address - Country:US
Practice Address - Phone:314-353-5190
Practice Address - Fax:314-353-1310
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO108135208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209982701OtherMEDICAID
MO209982719Medicaid
G76207Medicare UPIN
MO063011200Medicare ID - Type Unspecified