Provider Demographics
NPI:1174880173
Name:CURTIS W LEE, M.D., INC.
Entity type:Organization
Organization Name:CURTIS W LEE, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-961-6655
Mailing Address - Street 1:24 MAUNA KEA ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3875
Mailing Address - Country:US
Mailing Address - Phone:808-961-6655
Mailing Address - Fax:877-767-4871
Practice Address - Street 1:24 MAUNA KEA ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3875
Practice Address - Country:US
Practice Address - Phone:808-961-6655
Practice Address - Fax:808-935-5680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI6209207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI12D0618965OtherCLIA
HI12D0618965OtherCLIA
HIE38391Medicare UPIN