Provider Demographics
NPI:1700825387
Name:LEE, MILLIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MILLIE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:844 KEMPSVILLE RD
Mailing Address - Street 2:STE 204
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3927
Mailing Address - Country:US
Mailing Address - Phone:757-261-0700
Mailing Address - Fax:757-261-0701
Practice Address - Street 1:844 KEMPSVILLE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3927
Practice Address - Country:US
Practice Address - Phone:757-261-0700
Practice Address - Fax:757-962-1254
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101227517207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA-001OtherTRICARE/ CHAMPUS
VA1700825387Medicaid
VA2161776OtherUHC/MAMSI
VAPAROtherCORVEL/CORCARE
VAPAROtherVIRGINIA PREMIER HEALTH
VA010147361Medicaid
NC5900444Medicaid
VA93673OtherOPTIMA HEALTH PLAN
VAPAROtherUSA MANAGED CARE
VA2131997OtherMAMSI
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA175624OtherANTHEM BC/BS AND HKP
VAPAROtherCIGNA
VAPAROtherMULTIPLAN
NC00444OtherBC/BS
VA10015343OtherSENTARA OPTIMA
VA281332OtherANTHEM
VAPAROtherAETNA
VAPAROtherVIRGINIA HEALTH NETWORK
VA175624OtherANTHEM BC/BS AND HKP
VA2131997OtherMAMSI
VAP00217274Medicare PIN
VA012899E30Medicare PIN