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General NPI Number Information
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NPI Number | 1114109410
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Entity Type | Organization
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Legal Business Name | CHONG W. LEE, M.D., P.C.
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 4901 SEMINARY ROAD, #110
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City | ALEXANDRIA
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State | VA
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Zip | 22311
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Country | US
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Telephone | 703-379-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 4901 SEMINARY ROAD, #110
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City | ALEXANDRIA
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State | VA
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Zip | 22311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHONG W LEE
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Credential | M.D.
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Telephone | 703-379-1616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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