Individual
SUSAN ANNE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3600 JOSEPH SIEWICK DR, FAIRFAX, VA 22033-1709
(703) 391-3129
(703) 295-9369
Mailing address
PO BOX 37090, BALTIMORE, MD 21297-3090
(703) 295-9360
(703) 295-9369
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0102201986
VA
207L00000X
Anesthesiology Physician
25MB08070900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128210
—
NJ
05
—
1639282122
—
VA
Enumeration date
08/17/2006
Last updated
10/13/2008
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