NPIMap

Organization Active NPI

Kevin Lee, MD PC

  • Specialist
  • Walled Lake, MI
National Provider Identifier
1306035282
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
KEVIN LEE, MD PC
Practice address
136 S Pontiac TRL # 2
Walled Lake, MI 48390-3349
Phone
(248) 926-4292
NPI assigned
Oct 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kevin R Lee, MDNPI 1497882724
Title
Owner
Phone
(248) 926-4292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

136 S Pontiac TRL # 2
Walled Lake, MI 48390-3349

Mailing address

136 S Pontiac TRL # 2
Walled Lake, MI 48390-3349
Phone (248) 926-4292

National Provider Directory

National Provider Directory

Locations

136 S Pontiac Trl
#2
Walled Lake, MI 48390
Phone (248) 926-4292

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1306035282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 S PONTIAC TRL # 2",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903349",
            "telephone_number": "248-926-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S PONTIAC TRL # 2",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903349",
            "telephone_number": "248-926-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN LEE, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-926-4292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walled Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.