Healthcare Provider Details

I. General information

NPI: 1699297382
Provider Name (Legal Business Name): ANNE VICTORIA LEE M.D. MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNE V LEE MD, MPH

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 WASHINGTON HTS
ANN ARBOR MI
48109-2029
US

IV. Provider business mailing address

5048 MACDONOUGH PL
FREDERICK MD
21703-7671
US

V. Phone/Fax

Practice location:
  • Phone: 734-647-1120
  • Fax: 734-936-2084
Mailing address:
  • Phone: 415-793-3705
  • Fax: 415-728-9722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberD96782
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberD96782
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberMD478071
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number4301501716
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number4301501716
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberA68321
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberDR.0069713
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: