Provider Demographics
NPI:1346401312
Name:LEE, ANDY M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:M
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:BETH ISRAEL DEACONESS MEDICAL CENTER
Mailing Address - Street 2:DIVISION OF VASCULAR AND ENDOVASCULAR SURGERY SUITE 5B
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:508-598-9355
Mailing Address - Fax:
Practice Address - Street 1:61 LINCOLN ST STE 101
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8264
Practice Address - Country:US
Practice Address - Phone:508-598-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-22
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAFL2623172086S0129X
MA2369022086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty