# ROGER A LEWIS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cranberry Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508981291
- **Authorized official:** NORMA KEIM (OFFICE MANAGER)
- **Authorized official phone:** (304) 789-2457

## Contact information

- **Practice address:** 603B W STATE AVE, TERRA ALTA, WV 26764-1223
- **Practice address phone:** (304) 789-2457
- **Practice address fax:** (304) 789-6812
- **Mailing address:** 603B W STATE AVE, TERRA ALTA, WV 26764-1223
- **Mailing address phone:** (304) 789-2457
- **Mailing address fax:** (304) 789-6812

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 12705 | WV | Yes |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 02/08/2010