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Individual
DR. GARRETT RUSSELL LEWELLEN
Active
Individual
DR. GARRETT RUSSELL LEWELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2460
MA
111N00000X
Chiropractor
Primary
CR1311
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022072
ANTHEM PROVIDER NUMBER
ME
01
—
1092630
AETNA PROVIDER NUMBER
ME
01
—
1255431755
MEDICARE PTAN UX2253
ME
01
—
351404
HARVARD PILGRAM PROVIDER
ME
01
—
55-0850500
MARCHIGONNE PROVIDER #
ME
01
—
8546678
CIGNA PROVIDER #
ME
Enumeration date
09/24/2006
Last updated
11/30/2015
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