Provider Demographics
NPI:1790874626
Name:LEE, DANIEL ON-FAI (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ON-FAI
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 FLEMINGSBURG RD
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1015
Mailing Address - Country:US
Mailing Address - Phone:606-780-5500
Mailing Address - Fax:606-780-5512
Practice Address - Street 1:245 FLEMINGSBURG RD
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-1015
Practice Address - Country:US
Practice Address - Phone:606-780-5500
Practice Address - Fax:606-780-5512
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY462462084N0400X, 2084S0012X, 2084N0400X
NC351582084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100257030Medicaid
KY46246OtherLICENSE
NC48298OtherMEDCOST
NC8951418Medicaid
NC51418OtherBCBS
NC0481930001OtherMNSC
NC48298OtherMEDCOST