Provider Demographics
NPI:1629005434
Name:LEE, COLIN D (MD)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:D
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:221 MAHALANI STREET
Mailing Address - Street 2:PHYSICIAN PRACTICE SERVICES
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2526
Mailing Address - Country:US
Mailing Address - Phone:808-242-2528
Mailing Address - Fax:808-442-5067
Practice Address - Street 1:221 MAHALANI STREET
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2526
Practice Address - Country:US
Practice Address - Phone:808-244-9056
Practice Address - Fax:208-322-1695
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDM7488207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology