Provider Demographics
NPI:1821085606
Name:LEE, STEVEN R (M D)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:LEE
Suffix:
Gender:M
Credentials:M D
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Mailing Address - Street 1:2150 PEACHFORD RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6520
Mailing Address - Country:US
Mailing Address - Phone:770-452-0270
Mailing Address - Fax:770-457-8517
Practice Address - Street 1:2150 PEACHFORD RD
Practice Address - Street 2:SUITE F
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6520
Practice Address - Country:US
Practice Address - Phone:770-452-0270
Practice Address - Fax:770-457-8517
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0233782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00243878CMedicaid
GAD70534Medicare UPIN