Provider Demographics
NPI:1134564453
Name:LEE, SUSAN MING (MD, FRCPC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MING
Last Name:LEE
Suffix:
Gender:F
Credentials:MD, FRCPC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:530 ALBERTA AVENUE
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N4V 1H2
Mailing Address - Country:CA
Mailing Address - Phone:519-290-5888
Mailing Address - Fax:604-224-3400
Practice Address - Street 1:521 PARNASSUS AVE RM C455
Practice Address - Street 2:BOX 0648
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2206
Practice Address - Country:US
Practice Address - Phone:415-476-9035
Practice Address - Fax:415-514-1532
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125338207L00000X
ZZ86795207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology