Lee, Samuel Theodore

Lee, Samuel Theodore is an sole proprietor health care provider with primary practice located at 2845 Greenbrier Rd , Green Bay WI 54311-6519. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is his primary health care specialty. Lee, Samuel Theodore can be contacted via phone (920) 288-8000.

Contact Information

Primary practice address
2845 Greenbrier Rd Green Bay WI 54311-6519
Phone: (920) 288-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 125.061701 Illinois
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 22495 Wisconsin

Profile Details

NPI number 1184989436
LBN Legal business name Lee, Samuel Theodore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 11th, 2012
Last updated Jun 13th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184989436 NPPES
Wisconsin MEDICAID 100203539

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