Provider Demographics
NPI:1275635781
Name:LEE, MAUREEN THERESE (DO)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:THERESE
Last Name:LEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 BARRA RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9446
Mailing Address - Country:US
Mailing Address - Phone:207-286-3504
Mailing Address - Fax:207-286-3767
Practice Address - Street 1:57 BARRA RD
Practice Address - Street 2:SUITE #1
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9448
Practice Address - Country:US
Practice Address - Phone:207-286-3504
Practice Address - Fax:207-286-3767
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME1493207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME303240099Medicaid
MEF85915OtherHARVARD PILGRIM
ME011480OtherANTHEM
MEM98344COtherCIGNA
ME2733006OtherAETNA
ME011480OtherANTHEM
MEMM6131Medicare PIN
ME303240099Medicaid