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Individual
MR. JONATHAN SCOTT LEWIS
Active
Individual
MR. JONATHAN SCOTT LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006451L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013902500
—
PA
05
—
0013902500006
—
PA
01
—
01425101
CAPITAL BC PIN
PA
01
—
033040
BLUE SHIELD PIN
PA
01
—
0659812000
PERSONAL CHOICE
PA
01
—
2119174
AETNA
PA
01
—
54238503
CAREFIRST PIN
MD
01
—
5819531
AETNA
PA
01
—
T7090001
CAREFIRST NATIONAL PIN
MD
Enumeration date
04/10/2006
Last updated
02/14/2018
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