Provider Demographics
NPI:1952352338
Name:LEE, HERMAN G (MD)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:G
Last Name:LEE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:150 S HUNTINGTON AVE
Mailing Address - Street 2:PRIMARY CARE CLINIC
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4817
Mailing Address - Country:US
Mailing Address - Phone:857-364-4418
Mailing Address - Fax:857-364-6546
Practice Address - Street 1:150 S HUNTINGTON AVE
Practice Address - Street 2:PRIMARY CARE CLINIC
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-4817
Practice Address - Country:US
Practice Address - Phone:857-364-4418
Practice Address - Fax:857-364-6546
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2009-04-02
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Provider Licenses
StateLicense IDTaxonomies
MA45932207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA45932OtherREGISTRY OF MEDICINE