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Organization
PEDIATRIC AND ADOLESCENT CENTER
Active
Organization
PEDIATRIC AND ADOLESCENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP L LEWIS (OWNER)
(303) 758-0005
Entity
Organization
Contact information
Practice address
3400 S ONEIDA WAY, SUITE 101, DENVER, CO 80224-2850
(303) 758-0005
(303) 756-8077
Mailing address
3400 S ONEIDA WAY, SUITE 101, DENVER, CO 80224-2850
(303) 758-0005
(303) 756-8077
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
12100
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99173824
—
CO
Enumeration date
04/12/2007
Last updated
06/25/2008
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