Provider Demographics
NPI:1477548634
Name:LEE, HOWARD H (MD)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:H
Last Name:LEE
Suffix:
Gender:M
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 245
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44061-0245
Mailing Address - Country:US
Mailing Address - Phone:440-205-9119
Mailing Address - Fax:440-205-9209
Practice Address - Street 1:9485 MENTOR AVE
Practice Address - Street 2:STE 115, OAKTREE CLINIC
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4597
Practice Address - Country:US
Practice Address - Phone:440-205-9119
Practice Address - Fax:440-205-9209
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062594L2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0899452Medicaid
F03224Medicare UPIN
OH0899452Medicaid