Provider Demographics
NPI:1417958489
Name:LEE, ROBERT A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7147 VISTA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-9313
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:5501 NW 86TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131
Practice Address - Country:US
Practice Address - Phone:515-875-9035
Practice Address - Fax:515-875-9036
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2021-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAMD-28131207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAE96566Medicare UPIN
IAE96566Medicare UPIN