Provider Demographics
NPI:1588807721
Name:LE, ISABELLE PHUONG (MD)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:PHUONG
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3040 WILLIAMS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4618
Mailing Address - Country:US
Mailing Address - Phone:571-350-8400
Mailing Address - Fax:703-940-8692
Practice Address - Street 1:1635 N GEORGE MASON DR STE 170
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3633
Practice Address - Country:US
Practice Address - Phone:571-350-8400
Practice Address - Fax:703-528-0338
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2023-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301095821207RH0003X
MI390200000X
VA0101275894207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1588807721Medicaid
DC2L7996OtherMEDICARE DC METRO