Provider Demographics
NPI:1770572349
Name:LEES, CLAUDE DOUGLAS (MD)
Entity type:Individual
Prefix:
First Name:CLAUDE
Middle Name:DOUGLAS
Last Name:LEES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25599 KELLY RD
Mailing Address - Street 2:STE A
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4975
Mailing Address - Country:US
Mailing Address - Phone:586-772-6000
Mailing Address - Fax:586-772-7700
Practice Address - Street 1:25599 KELLY RD
Practice Address - Street 2:STE A
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4975
Practice Address - Country:US
Practice Address - Phone:586-772-6000
Practice Address - Fax:586-772-7700
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI047134208G00000X
OH35. 044044174400000X
IN01071700A208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICD7957OtherRAILROAD MEDICARE
IN000000843713OtherANTHEM PROVIDER NUMBER
MI3369425Medicaid
MI4714871Medicaid
MI3377561Medicaid
MICD7959OtherRAILROAD MEDICARE
IN201196730Medicaid
MI3369425Medicaid
MI3369425Medicaid
MI4714871Medicaid
MI$$$$$$$$$OtherTRICARE
IN000000843713OtherANTHEM PROVIDER NUMBER