Provider Demographics
NPI:1982924619
Name:LEE, TINA XIANG (MD)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:XIANG
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4045 E BELL RD
Mailing Address - Street 2:STE 134
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2234
Mailing Address - Country:US
Mailing Address - Phone:614-702-7899
Mailing Address - Fax:
Practice Address - Street 1:2260 MORSE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-5858
Practice Address - Country:US
Practice Address - Phone:614-702-7899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ62301207Q00000X
OH35-120250207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine