Individual
SUSANNE BLANCHETTE MACKIE-LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD MPH
Contact information
Practice address
7500 IRON BAR LN, GAINESVILLE, VA 20155
(703) 753-6772
Mailing address
1300 PICCARD DR, STE 202, ROCKVILLE, MD 20850-4303
(301) 921-7900
(301) 921-7915
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101055325
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006731911
—
VA
Enumeration date
11/02/2005
Last updated
08/17/2019
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