Provider Demographics
NPI:1235572322
Name:LEE, MICHAEL ANTHONY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:LEE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:300 LONGWOOD AVE BCH3066
Mailing Address - Street 2:DIVISON OF EMERGENCY MEDICINE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-6624
Mailing Address - Fax:617-730-0335
Practice Address - Street 1:300 LONGWOOD AVE BCH3066
Practice Address - Street 2:DIVISON OF EMERGENCY MEDICINE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-6624
Practice Address - Fax:617-730-0335
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2016-08-23
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Provider Licenses
StateLicense IDTaxonomies
MA2659012080P0204X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program