NPIMap

Organization Active NPI

Lee Marshall DO PC

  • Neurology Physician
  • Southfield, MI
National Provider Identifier
1528124161
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
LM010950 Issued in MI
Legal business name
LEE MARSHALL DO PC
Practice address
29829 Telegraph Rd
Suite 202
Southfield, MI 48034-1330
Phone
(248) 208-9411
Fax
(248) 208-9417
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Authorized official

Name
Lee Bruce Marshall, DO
Title
Physician Neurologist President
Phone
(248) 208-9411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X LM010950 MI Primary

Addresses

Primary practice location

29829 Telegraph Rd
Suite 202
Southfield, MI 48034-1330

Mailing address

29829 Telegraph Rd
Suite 202
Southfield, MI 48034-1330
Phone (248) 208-9411

Other identifiers 3

IdentifierTypeStateIssuer
114567651MedicaidMI
1356310544OtherMIBCBS
P00141408OtherMIPALMETTO

National Provider Directory

National Provider Directory

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": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1528124161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29829 TELEGRAPH RD",
            "address_2": "SUITE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341330",
            "telephone_number": "248-208-9411",
            "fax_number": "248-208-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29829 TELEGRAPH RD",
            "address_2": "SUITE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341330",
            "telephone_number": "248-208-9411",
            "fax_number": "248-208-9417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE MARSHALL DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PHYSICIAN NEUROLOGIST PRESIDENT",
        "authorized_official_telephone_number": "248-208-9411",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "LM010950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114567651",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1356310544",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "P00141408",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; 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.