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Individual
COREY LEWIS
Active
Individual
COREY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.0006653
CO
363A00000X
Physician Assistant
PA2126
TN
363AS0400X
Surgical Physician Assistant
Primary
PA218898
OR
Other
Enumeration date
04/20/2012
Last updated
06/17/2025
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