Provider Demographics
NPI:1992866271
Name:LEE, LONNIE JOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LONNIE
Middle Name:JOAN
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LONNIE
Other - Middle Name:JOAN
Other - Last Name:WEINHEIMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:PPQA MEDICARE COMPLIANCE UNIT 6 W ATTN THERESA BROOKS
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:6525 BELCREST ROAD
Practice Address - Street 2:SUITE 160
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-2003
Practice Address - Country:US
Practice Address - Phone:301-209-6218
Practice Address - Fax:301-209-6284
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231749207Q00000X
MDD0053582207Q00000X
MDU00870171100000X
DCMD039321207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
005160M92Medicare ID - Type Unspecified
F50408Medicare UPIN