Provider Demographics
NPI:1326052184
Name:LEE, JAMES J (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44320 PREMIER PLAZA
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5076
Mailing Address - Country:US
Mailing Address - Phone:703-723-8727
Mailing Address - Fax:703-723-9787
Practice Address - Street 1:44320 PREMIER PLAZA
Practice Address - Street 2:SUITE 110
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5076
Practice Address - Country:US
Practice Address - Phone:703-723-8727
Practice Address - Fax:703-723-9787
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237837207YX0602X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2179242OtherONE NET
VA5889390OtherCIGNA
VA1326052184Medicaid
VA7564667OtherAETNA
VAD393-0002OtherCAREFIRST BCBS
VA5889390OtherCIGNA