| Doctor Name: | MR. DEREK LEE |
| NPI Number: | 1790042083 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CNMT, PET |
| License Number: | CNMT-00404 |
| Business Practice Address: | 28322 N 223rd Ln Wittmann, AZ - 853618780 |
| Business Phone Number: | 6233882909 |
| Business Fax Number: | 6233882909 |
| Mailing Address: | 28322 N 223rd Ln, WITTMANN |
| State: | AZ |
| Postal Code: | 853618780 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/12/2012 |
| NPI Last Update Date: | 04/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471N0900X |
| License Number: | CNMT-00404 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Nuclear Medicine Technology |
| Taxonomy Definition: | |