Individual
DR. CONNIE DIEM KHANH LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4208 EVERGREEN LN STE 214, ANNANDALE, VA 22003-3254
(703) 642-6633
(703) 642-6699
Mailing address
4208 EVERGREEN LN STE 214, ANNANDALE, VA 22003-3254
(703) 642-6633
(703) 642-6699
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101237697
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010189721
—
VA
05
—
036849700
—
DC
01
—
178649
ANTHEM PROVIDER ID #
VA
01
—
202907076
TRICARE STANDARD
VA
01
—
2536483
UNITED HEALTH CARE
VA
05
—
408479900
—
MD
01
—
7120704
AETNA NON HMO
VA
01
—
720471
NCPPO
VA
01
—
9166111
CIGNA
VA
01
—
9389238
ALLIED BENEFITS SYSTEM
VA
01
—
G02045C01
MEDICARE PTAN
VA
01
—
K8390001
BLUE CROSS BLUE SHIELD
VA
Enumeration date
09/27/2006
Last updated
09/27/2023
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