Provider Demographics
NPI:1255390217
Name:LEE, LINDA M (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:910 HAMPRESTON COURT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041
Mailing Address - Country:US
Mailing Address - Phone:585-943-3166
Mailing Address - Fax:585-271-6282
Practice Address - Street 1:5755 NORTH POINT PARKWAY
Practice Address - Street 2:SUITE #74
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022
Practice Address - Country:US
Practice Address - Phone:770-667-3006
Practice Address - Fax:770-667-3311
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY180351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF09996Medicare UPIN
NYDD4786Medicare ID - Type Unspecified