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Individual

ALICE JISOO LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
13890 BRADDOCK ROAD, STE 201, CENTREVILLE, VA 20121
(703) 988-8828
(571) 526-5598
Mailing address
13890 BRADDOCK ROAD, STE 201, CENTREVILLE, VA 20121
(703) 988-8828
(571) 526-5598

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101269805
VA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/25/2016
Last updated
08/09/2024
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