Basic Information
| Provider Information | |||||||||
| NPI: | 1184877151 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KNEER | ||||||||
| FirstName: | LEE | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | EMORY UNIVERSITY | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303220001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047276123 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | EMORY UNIVERSITY | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303220001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047276123 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2008 | ||||||||
| LastUpdateDate: | 08/11/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 7151986-8905 | UT | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 7151986-1205 | UT | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 01069420A | IN | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 201016990 | 05 | IN | MEDICAID |