Individual
KEREN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5000
Mailing address
10101 GROSVENOR PL APT 1311, ROCKVILLE, MD 20852-4677
(858) 722-4344
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
208D00000X
General Practice Physician
Primary
0101283053
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2023
Last updated
07/02/2024
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