| Doctor Name: | DR. CHARLES R LEE |
| NPI Number: | 1689699258 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | CL007632 |
| Business Practice Address: | 22100 Greenfield Rd Oak Park, MI - 482372550 |
| Business Phone Number: | 2484701503 |
| Business Fax Number: | |
| Mailing Address: | 22100 Greenfield Rd, OAK PARK |
| State: | MI |
| Postal Code: | 482372550 |
| Phone Number: | 2484701503 |
| Fax Number: | |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 07/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | CL007632 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |