Provider Demographics
NPI:1427184290
Name:LEE, CINDY S C (MD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:S C
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
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 42873
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-0873
Mailing Address - Country:US
Mailing Address - Phone:513-793-8218
Mailing Address - Fax:513-793-8218
Practice Address - Street 1:9120 HOFFMAN FARM LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7314
Practice Address - Country:US
Practice Address - Phone:513-793-8218
Practice Address - Fax:513-793-8218
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35036868207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0455798Medicaid
OH0455798Medicaid
LE0493652Medicare ID - Type Unspecified
OH0455798Medicaid