Provider Demographics
NPI:1518922459
Name:LEE, HEATHER M (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 418837
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8837
Mailing Address - Country:US
Mailing Address - Phone:888-846-5527
Mailing Address - Fax:607-324-2369
Practice Address - Street 1:8116 GOOD LUCK RD STE LL05
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3502
Practice Address - Country:US
Practice Address - Phone:240-542-3060
Practice Address - Fax:240-542-3061
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00618852085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD3624169OtherAETNA HMO
MD00002439430 02OtherUNITED HEALTHCARE/AMERICH
MD002433300Medicaid
DC29020014OtherCAREFIRST BC/BS
MD0578734OtherCIGNA
MD101900OtherJOHNS HOPKINS HEALTHCARE
MD2233148OtherFIRST HEALTH/CCN
MD4584OtherELDER HEALTH
DC0037166300Medicaid
MD268375OtherAMERIGROUP
MD60332703OtherCAREFIRST BC/BS
MD671070OtherNATIONAL CAPITOL PPO
MD7382571OtherAETNA PPO
MD00002439430 02OtherUNITED HEALTHCARE/AMERICH
DC29020014OtherCAREFIRST BC/BS
MDI20182Medicare UPIN