Individual
SAMUEL SANG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7901 LAKE MANASSAS DR, GAINESVILLE, VA 20155-3257
(571) 222-2200
(571) 222-2202
Mailing address
3040 WILLIAMS DR STE 100, FAIRFAX, VA 22031-4618
(571) 350-8400
(571) 222-2202
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101266589
VA
207RH0000X
Hematology (Internal Medicine) Physician
0101266589
VA
207RH0003X
Hematology & Oncology Physician
Primary
0101266589
VA
207RX0202X
Medical Oncology Physician
0101266589
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710320718
—
VA
01
—
2J9538
MEDICARE PTAN
DC
01
—
VVW001A
MEDICARE PTAN
VA
Enumeration date
04/10/2013
Last updated
11/03/2025
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