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Individual
TRAVIS J LEWIS
Active
Individual
TRAVIS J LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA053415
PA
363AM0700X
Medical Physician Assistant
MA053415
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031676650001
—
PA
05
—
1031676650002
—
PA
05
—
1031676650003
—
PA
Enumeration date
06/29/2008
Last updated
11/17/2023
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