# WENDELL R LEWIS JR.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1508058009
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 01323 | WV | — |
| 363A00000X | Physician Assistant | 01323 | WV | Yes |
| 363A00000X | Physician Assistant | C05465 | MD | — |

## Other

- **Enumeration date:** 08/17/2007
- **Last updated:** 07/13/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0110002558 | LICENSE | VA |
| 01 | — | 01323 | WEST VIRGINIA LICENSE | WV |
| 01 | — | MA053081 | PENNSYLVANIA PA LICENSE | PA |