Provider Demographics
NPI:1740429372
Name:LEE, SANG MI (MD)
Entity Type:Individual
Prefix:DR
First Name:SANG MI
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 W CLARENDON AVE
Mailing Address - Street 2:SUITE 142
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3449
Mailing Address - Country:US
Mailing Address - Phone:602-234-1803
Mailing Address - Fax:602-234-3748
Practice Address - Street 1:300 W CLARENDON AVE
Practice Address - Street 2:SUITE 142
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3449
Practice Address - Country:US
Practice Address - Phone:602-234-1803
Practice Address - Fax:602-234-3748
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ41382207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z130473Medicare PIN