Provider Demographics
NPI:1891093944
Name:LE, HIEP VAN
Entity Type:Individual
Prefix:DR
First Name:HIEP
Middle Name:VAN
Last Name:LE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 933
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-0933
Mailing Address - Country:US
Mailing Address - Phone:678-897-1375
Mailing Address - Fax:276-322-7547
Practice Address - Street 1:12 WESTWOOD MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-2000
Practice Address - Country:US
Practice Address - Phone:678-897-1375
Practice Address - Fax:276-322-7547
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102203040207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine