Provider Demographics
NPI:1275987869
Name:LEE, JOSHUA (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 980695
Mailing Address - Street 2:WEST HOSPITAL, 7TH FLOOR, NORTH WING
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0695
Mailing Address - Country:US
Mailing Address - Phone:804-828-0733
Mailing Address - Fax:804-828-8682
Practice Address - Street 1:11958 W BROAD ST
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1007
Practice Address - Country:US
Practice Address - Phone:804-828-0733
Practice Address - Fax:804-828-8682
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101263103207LP2900X
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine