Provider Demographics
NPI:1831106764
Name:LEE, BENJAMIN I (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:I
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 1:1133 21ST ST NW STE 700
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3372
Mailing Address - Country:US
Mailing Address - Phone:202-416-2000
Mailing Address - Fax:202-416-2007
Practice Address - Street 1:106 IRVING ST., NW
Practice Address - Street 2:STE 4800N
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-723-5524
Practice Address - Fax:202-291-0512
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD14064207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD558641100Medicaid
DC409629Medicare PIN
DCC62483Medicare PIN
MDC15430Medicare PIN