Provider Demographics
NPI:1780624536
Name:PERRY, LEE CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:CHARLES
Last Name:PERRY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1085 S LINDEN RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3421
Mailing Address - Country:US
Mailing Address - Phone:810-732-3240
Mailing Address - Fax:810-230-0280
Practice Address - Street 1:G-1125 SOUTH LINDEN ROAD
Practice Address - Street 2:SUITE 900
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532
Practice Address - Country:US
Practice Address - Phone:810-733-7791
Practice Address - Fax:810-733-7898
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
MI4301079288207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C31662Medicare UPIN