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NPI Code Detail

MEDICARE: DR. DONG HEUN LEE M.D.

MEDICARE: DR. DONG HEUN LEE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician0101243207VA

General Provider Information

NPI Number : 1629048723
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONG HEUN LEE M.D.
Provider Business Mailing Address
First Line : 1031 CARE WAY
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-8425
Country : US
Telephone Number : 540-371-7600
Fax Number :
Provider Business Practice Location Address
First Line : 1031 CARE WAY
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-8425
Country : US
Telephone Number : 540-371-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 03/16/2012

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