Provider Demographics
NPI:1700059490
Name:DENISE Y. LEE, DO, PLLC
Entity type:Organization
Organization Name:DENISE Y. LEE, DO, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-364-4064
Mailing Address - Street 1:3100 CROSS CREEK PKWY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2775
Mailing Address - Country:US
Mailing Address - Phone:248-364-4064
Mailing Address - Fax:248-371-1930
Practice Address - Street 1:3100 CROSS CREEK PKWY
Practice Address - Street 2:SUITE 160
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2775
Practice Address - Country:US
Practice Address - Phone:248-364-4064
Practice Address - Fax:248-371-1930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherTAX ID