Provider Demographics
NPI:1881213296
Name:LEE, DANIELLE (MD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 LADY BLAIR LN UNIT 74188
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-5007
Mailing Address - Country:US
Mailing Address - Phone:858-353-2740
Mailing Address - Fax:
Practice Address - Street 1:7501 LADY BLAIR LN UNIT 74188
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-5007
Practice Address - Country:US
Practice Address - Phone:858-353-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101282728207Q00000X
CAA176848207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine