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General NPI Number Information
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NPI Number | 1639282122
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Entity Type | Individual
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Provider Name | SUSAN ANNE LEE DO
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Gender | Female
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 10/13/2008
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Provider Practice Location Address
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Address Line | 3600 JOSEPH SIEWICK DR
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City | FAIRFAX
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State | VA
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Zip | 22033-1709
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Country | US
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Telephone | 703-391-3129
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Fax | 703-295-9369
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Provider Business Mailing Address
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Address Line | PO BOX 37090
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City | BALTIMORE
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State | MD
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Zip | 21297-3090
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Country | US
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Telephone | 703-295-9360
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Fax | 703-295-9369
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MB08070900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0102201986
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License Number State | VA
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