Individual
DR. BRENT R LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4320 SEMINARY RD, ALEXANDRIA, VA 22304-1535
(703) 504-4270
Mailing address
3998 FAIR RIDGE DR, STE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
0101232682
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050086420
RAILROAD MEDICARE
VA
05
—
1932290376
—
VA
01
—
219815
ANTHEM
VA
01
—
297893
AMERIGROUP
VA
01
—
493812
NCPPO
VA
01
—
K142-0001
CARE FIRST 2005
VA
Enumeration date
09/28/2006
Last updated
12/16/2014
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