Provider Demographics
NPI:1255353694
Name:LEE, JOSEPH Y (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:Y
Last Name:LEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 SHINGLE CREEK PKWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2128
Mailing Address - Country:US
Mailing Address - Phone:763-561-5349
Mailing Address - Fax:763-561-7792
Practice Address - Street 1:2085 RICE ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-6807
Practice Address - Country:US
Practice Address - Phone:651-489-9035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN41198207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN135419C028OtherU-CARE
MN877G6LEOtherBCBS
MN1046268OtherPREFERRED ONE
MN3100324OtherMEDICA
MNHP60190OtherHEALTHPARTNERS
MN539137700Medicaid
WI43528800Medicaid
MNP00320138Medicare PIN
MN539137700Medicaid
MN135419C028OtherU-CARE