Provider Demographics
NPI:1346209871
Name:LEE, SUE HOLLOWELL (MD, FAAP)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:HOLLOWELL
Last Name:LEE
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416
Mailing Address - Street 2:
Mailing Address - City:BAYBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28515-0416
Mailing Address - Country:US
Mailing Address - Phone:252-745-2070
Mailing Address - Fax:252-745-2202
Practice Address - Street 1:13531 NC HIGHWAY 55
Practice Address - Street 2:
Practice Address - City:BAYBORO
Practice Address - State:NC
Practice Address - Zip Code:28515-0000
Practice Address - Country:US
Practice Address - Phone:252-745-2070
Practice Address - Fax:252-745-2202
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0039010208000000X
NC00-39010208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891215XMedicaid
NC891215XMedicaid