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General NPI Number Information
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NPI Number | 1447679212
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Entity Type | Individual
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Provider Name | BRIAN LEE MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 450 GARRISONVILLE RD STE 109
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City | STAFFORD
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State | VA
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Zip | 22554-1615
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Country | US
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Telephone | 35-222-7277
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Fax | 703-542-3753
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Provider Business Mailing Address
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Address Line | 15512 MORAVIA CT
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City | DERWOOD
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State | MD
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Zip | 20855-2716
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | D0094640
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License Number State | MD
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