# DR. GIDEON GRIFFETH LEWIS

> 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:** No

## Provider details

- **NPI number:** 1508845116
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | ME 29256 | FL | — |
| 207QA0505X | Adult Medicine Physician | ME 29256 | FL | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | ME 29256 | FL | — |

## Other

- **Enumeration date:** 01/12/2006
- **Last updated:** 04/28/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 064809400 | — | FL |
| 01 | — | 080137252 | RAILROAD MEDICARE ID | FL |
| 01 | — | 2134653 | AETNA HMO ID | FL |
| 01 | — | 2403499008 | CIGNA HEALTHCARE ID | FL |
| 01 | — | 4311031 | AETNA PPO/POS ID | FL |
| 01 | — | 59249 | BCBS ID | FL |
| 01 | — | ME 29256 | STATE LICENSE | FL |