Provider Demographics
NPI:1972591550
Name:LEE, ANDREW TOON (DO)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:TOON
Last Name:LEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9910 FRANKLIN SQUARE DR # 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-5412
Mailing Address - Fax:410-933-1390
Practice Address - Street 1:1400 I ST NW STE 825
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005
Practice Address - Country:US
Practice Address - Phone:202-617-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-08
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102050256207R00000X
DCDO31453207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
71050002OtherBLUECROSS/BLUE SHIELD
7929081OtherAETNA HEALTHCARE
DC027140900Medicaid
500134OtherNCPPO
VA337638OtherANTHEM BC/BS
DC337639OtherANTHEM BC/BS
VA5861152Medicaid
MD773600200Medicaid
VA337638OtherANTHEM BC/BS
H01764Medicare UPIN