Provider Demographics
NPI:1801874599
Name:LEE, HUI BAE HAROLD (MD)
Entity type:Individual
Prefix:DR
First Name:HUI BAE
Middle Name:HAROLD
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:H. B.
Other - Middle Name:HAROLD
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 PENNSYLVANIA PKWY
Practice Address - Street 2:SUITE 225
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-2301
Practice Address - Country:US
Practice Address - Phone:317-573-1000
Practice Address - Fax:317-573-0205
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063258207W00000X
IN01063258A207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN103446400Medicaid
IN200869760Medicaid
IN200869760Medicaid
MN103446400Medicaid
MNP00166865Medicare ID - Type UnspecifiedRAILROAD
I14817Medicare UPIN