# KERRY R. LEWIS M.D. LTD.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508153602
- **Authorized official:** DR. KERRY RANDALL LEWIS M.D. (PHYSICIAN)
- **Authorized official phone:** (703) 273-3613

## Contact information

- **Practice address:** 10560 MAIN ST, SUITE 210, FAIRFAX, VA 22030-7182
- **Practice address phone:** (703) 273-3613
- **Mailing address:** 10560 MAIN ST, SUITE 210, FAIRFAX, VA 22030-7182
- **Mailing address phone:** (703) 273-3613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | 0101028949 | VA | Yes |

## Other

- **Enumeration date:** 07/09/2011
- **Last updated:** 07/09/2011