Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 5101017531 | MI |
Y | 207R00000X | Internist | 0102206014 | VA |
Y | 111NI0900X | Internist | 0102206014 | VA |
NPI | 1023201977 |
---|---|
Provider Name | Dr. Caleb Lee |
First Address | Glen Allen, VA 23060-9263 |
Second Address | Fairfax, VA 22030-2000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2007 |
Last Update Date | 03/11/2020 |