Individual
VINCENT LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5516 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23462-5629
(757) 473-3969
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
(757) 473-3969
(757) 473-3987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101056940
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
324289
ANTHEM
VA
05
—
5813735
—
VA
01
—
7906203
MEDICAID
NC
Enumeration date
01/24/2007
Last updated
03/25/2020
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