Provider Demographics
NPI:1245204429
Name:LEE, STEPHEN ERWIN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ERWIN
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 FORT COUCH RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1041
Mailing Address - Country:US
Mailing Address - Phone:412-831-0355
Mailing Address - Fax:412-854-5152
Practice Address - Street 1:180 FORT COUCH RD
Practice Address - Street 2:SUITE 304
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1041
Practice Address - Country:US
Practice Address - Phone:412-831-0355
Practice Address - Fax:412-854-5152
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025836E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PALE175126Medicare ID - Type Unspecified
C32827Medicare UPIN