Basic Information
| Provider Information | |||||||||
| NPI: | 1154717700 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LE | ||||||||
| FirstName: | SYLVIA | ||||||||
| MiddleName: | SOK | ||||||||
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| Credential: | M.D, | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 388 | ||||||||
| Address2: | |||||||||
| City: | FISHERSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229390388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5409325162 | ||||||||
| FaxNumber: | 5409325875 | ||||||||
| Practice Location | |||||||||
| Address1: | 2570 STUARTS DRAFT HWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | STUARTS DRAFT | ||||||||
| State: | VA | ||||||||
| PostalCode: | 244773237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5402457880 | ||||||||
| FaxNumber: | 5402457881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2015 | ||||||||
| LastUpdateDate: | 10/22/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 0101265108 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.