Provider Demographics
NPI:1396370581
Name:LEE, STEPHEN ALEXANDER (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALEXANDER
Last Name:LEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 MARTIN CT APT 721
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2577
Mailing Address - Country:US
Mailing Address - Phone:949-910-2989
Mailing Address - Fax:
Practice Address - Street 1:3127 UMATILLA ST APT 2
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5638
Practice Address - Country:US
Practice Address - Phone:949-910-2989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-08
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT020980207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine