MEDICARE: DR. PETER LEE JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0206X	Pediatric Gastroenterology Physician	0101055321	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740253020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER LEE JR. M.D.

Provider Business Mailing Address
First Line	:	3022 WILLIAMS DR
Second Line	:	SUITE 301
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4600
Country	:	US
Telephone Number	:	703-698-8960
Fax Number	:	703-641-8427

Provider Business Practice Location Address
First Line	:	3022 WILLIAMS DR
Second Line	:	SUITE 301
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4600
Country	:	US
Telephone Number	:	703-698-8960
Fax Number	:	703-641-8427

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	03/14/2016

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Directions to “ DR. PETER LEE JR. M.D.” Practice Location

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