Provider Demographics
NPI:1952301723
Name:LEE, TAMEKA R (DPM)
Entity Type:Individual
Prefix:
First Name:TAMEKA
Middle Name:R
Last Name:LEE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12366
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-2366
Mailing Address - Country:US
Mailing Address - Phone:205-780-7101
Mailing Address - Fax:205-206-8338
Practice Address - Street 1:832 PRINCETON AVENUE, S.W.
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1416
Practice Address - Country:US
Practice Address - Phone:205-206-8461
Practice Address - Fax:205-397-0586
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL196213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP00386681OtherMEDICARE RAILROAD
AL515-39089OtherBCBS
AL515-39089OtherBCBS
ALU71255Medicare UPIN