Provider Demographics
NPI:1568401099
Name:BUTTERFIELD, LEE O (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:O
Last Name:BUTTERFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:955 RIBAUT RD
Mailing Address - Street 2:BMAC CREDENTIALING
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5441
Mailing Address - Country:US
Mailing Address - Phone:843-522-5674
Mailing Address - Fax:843-522-5678
Practice Address - Street 1:BEAUFORT MEMORIAL HEART SPECIALIST
Practice Address - Street 2:300 MIDTOWN DR
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906
Practice Address - Country:US
Practice Address - Phone:843-770-0404
Practice Address - Fax:844-295-9872
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20046207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC200464Medicaid
SCSC07813257OtherMEDICARE
SC4433Medicare PIN