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DR. LEE EVERETT EDSTROM M.D.
NPI 1669566303
Plastic Surgery in Providence, RI

Active since October 03, 2006
2 DUDLEY, SUITE 460, PROVIDENCE, RI 02905(401) 331-2303(401) 331-4430 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Lee Everett Edstrom M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LEE EVERETT EDSTROM M.D. (NPI 1669566303) is an individual plastic surgery provider in Providence, Rhode Island, licensed in Rhode Island (5949) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1669566303
Entity TypeIndividualMale
Primary Taxonomy208200000X
Provider Legal NameDR. LEE EVERETT EDSTROMCredential: M.D.
Location Address2 DUDLEY, SUITE 460Providence, RI 02905
Mailing Address2 Dudley, Suite 460Providence, RI 02905 · (401) 331-2303 · Fax (401) 331-4430
Phone(401) 331-2303
Fax(401) 331-4430
Sole ProprietorYes
Enumeration DateOctober 3, 2006
Last NPPES UpdateMarch 7, 2023
✔ NPI 1669566303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in RI · 5949
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
2 DUDLEY, Providence, RI 02905
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Other Identifiers 3

Other1300121RI · United Health
Other300043RI · Bluechip
Other050395339RI · Tax Id

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lee Edstrom's NPI number?

The NPI number for Lee Edstrom is 1669566303. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Where is Lee Edstrom located?

Lee Edstrom practices at 2 Dudley Suite 460, Providence, RI 02905. The listed phone number is (401) 331-2303.

What is Lee Edstrom's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

When was this NPI record last updated?

The NPPES record for Lee Edstrom was last updated on March 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.