Provider Demographics
NPI:1770529323
Name:LEE, ROBERT HAMMILL (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HAMMILL
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2874 NC HWY 127 SOUTH
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-9130
Mailing Address - Country:US
Mailing Address - Phone:828-294-4100
Mailing Address - Fax:828-294-4112
Practice Address - Street 1:2874 NC HWY 127 SOUTH
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-9130
Practice Address - Country:US
Practice Address - Phone:828-294-4100
Practice Address - Fax:828-294-4112
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33541207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC51524OtherBCBS
NC0238GOtherBCBS GROUP
NC8951524Medicaid
NC2342928OtherMEDICARE GRUOP
NC890238GOtherMEDICAID GROUP
NC0238GOtherBLUE CROSS GROUP
NC51524OtherBCBS IND
NC2335809OtherMEDICARE GROUP
NC890238GMedicaid
NC0238GOtherBLUE CROSS GROUP
NC2342928OtherMEDICARE GRUOP
NCC34083Medicare UPIN
NC213572BMedicare ID - Type Unspecified
NC213572CMedicare PIN