MEDICARE: DR. ANNE VICTORIA LEE M.D. MPH

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
1	2083B0002X	Obesity Medicine (Preventive Medicine) Physician	D96782	MD
2	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	D96782	MD
3	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	MD478071	PA
4	2083X0100X	Occupational Medicine Physician	4301501716	MI
5	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	4301501716	MI
6	2083P0901X	Public Health & General Preventive Medicine Physician	A68321	CA
7	2083P0901X	Public Health & General Preventive Medicine Physician	DR.0069713	CO

General Provider Information

NPI Number	:	1699297382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE VICTORIA LEE M.D. MPH

Provider Business Mailing Address
First Line	:	5048 MACDONOUGH PL
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21703-7671
Country	:	US
Telephone Number	:	415-793-3705
Fax Number	:	415-728-9722

Provider Business Practice Location Address
First Line	:	1415 WASHINGTON HTS
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48109-2029
Country	:	US
Telephone Number	:	734-647-1120
Fax Number	:	734-936-2084

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	06/27/2024

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