Healthcare Provider Details
I. General information
NPI: 1225155757
Provider Name (Legal Business Name): LEE MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2007
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
618 I ST NW
WASHINGTON DC
20001-3736
US
IV. Provider business mailing address
618 I ST NW
WASHINGTON DC
20001-3736
US
V. Phone/Fax
- Phone: 202-842-1118
- Fax: 202-842-4449
- Phone: 202-842-1118
- Fax: 202-842-4449
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREW
TOON
LEE
Title or Position: VICE PRESIDENT
Credential: D.O.
Phone: 202-842-1118