Provider Demographics
NPI:1669477352
Name:LEE, LUCIA M (MD)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3300 BUCKEYE RD
Mailing Address - Street 2:STE 178
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4232
Mailing Address - Country:US
Mailing Address - Phone:770-458-6103
Mailing Address - Fax:770-234-0437
Practice Address - Street 1:3300 BUCKEYE RD
Practice Address - Street 2:STE 178
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4232
Practice Address - Country:US
Practice Address - Phone:770-458-6103
Practice Address - Fax:770-234-0437
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA040948207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00681909AMedicaid
GA00681909AMedicaid
GAF78422Medicare UPIN