Provider Demographics
NPI:1043214810
Name:LEE, JAMES PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PAUL
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11717 OLD NATIONAL PIKE
Mailing Address - Street 2:#8
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774
Mailing Address - Country:US
Mailing Address - Phone:301-363-4663
Mailing Address - Fax:301-829-5820
Practice Address - Street 1:11717 OLD NATIONAL PIKE
Practice Address - Street 2:#8
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774
Practice Address - Country:US
Practice Address - Phone:301-363-4663
Practice Address - Fax:301-829-5820
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2009-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD00335312080A0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402541500Medicaid