Individual
MR. GERALD K LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD
Contact information
Practice address
8551 RIXLEW LANE, SUITE 140, MANASSAS, VA 20109-4278
(703) 361-4357
(703) 361-0346
Mailing address
P.O. BOX 2041, MANASSAS, VA 20108-0815
(703) 361-4357
(703) 361-0346
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
0101057543
VA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
D0054211
MD
208D00000X
General Practice Physician
0101057543
VA
208D00000X
General Practice Physician
01010575543
VA
208D00000X
General Practice Physician
D0054211
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
182042
ANTHEM
VA
Enumeration date
01/09/2008
Last updated
05/20/2024
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