Provider Demographics
NPI:1598932428
Name:LEE, PETER HU (MD, PHD, MPH)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:HU
Last Name:LEE
Suffix:
Gender:M
Credentials:MD, PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:300 HANOVER ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5444
Practice Address - Country:US
Practice Address - Phone:508-973-7774
Practice Address - Fax:508-973-7724
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA283889208G00000X
OH35122517208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP01443444OtherRAILROAD MEDICARE
OH0096068Medicaid
OH0096068Medicaid