Provider Demographics
NPI:1437327095
Name:LEE BERNARD, CYNTHIA JUNE (DO)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:JUNE
Last Name:LEE BERNARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3301 NEW MEXICO AVE NW
Mailing Address - Street 2:SUITE #202
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3622
Mailing Address - Country:US
Mailing Address - Phone:202-686-9801
Mailing Address - Fax:202-363-6464
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:SUITE #202
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3622
Practice Address - Country:US
Practice Address - Phone:202-686-9801
Practice Address - Fax:202-363-6464
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102050187207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10057493Medicaid
VA013732C77Medicare PIN
VA10057493Medicaid