Provider Demographics
NPI:1023015609
Name:LEE, DANIEL C-S (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:C-S
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9120
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02027-9120
Mailing Address - Country:US
Mailing Address - Phone:781-329-1400
Mailing Address - Fax:781-278-5667
Practice Address - Street 1:1 LYONS ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-5599
Practice Address - Country:US
Practice Address - Phone:781-329-1400
Practice Address - Fax:781-278-5667
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA43433207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B99081OtherFIRST SENIORITY
0016048OtherNEIGHBORHOOD HEALTH PLAN
6176569OtherMASS HEALTH
2150387OtherHEALTHSOURCE MASSACHUSETT
2150387OtherCIGNA HEALTH CARE
27588OtherCHILDRENS MEDICAL SECURIT
3677OtherHARVARD PILGRIM PPO
E05641OtherBLUE SHIELD INDEMNITY
E05641OtherBS BLUE CARE ELECT
043433OtherTUFTS
043433OtherTUFTS BENEFIT ADMINISTRAT
MAE05641OtherBCBSMA
E05641OtherHMO BLUE/BLUE CHOICE
110116188OtherRAILROAD MEDICARE
3677OtherHARVARD PILGRIM POS
3677OtherHARVARD PILGRIM
MA6176569Medicaid
27588OtherCHILDRENS MEDICAL SECURIT
B99081Medicare UPIN
B99081OtherFIRST SENIORITY