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Individual

BRANDI LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1180 ERNEST W BARRETT PKWY NW STE 102B, KENNESAW, GA 30144
(678) 354-2273
Mailing address
1180 ERNEST W BARRETT PKWY NW STE 102B, KENNESAW, GA 30144-4534
(678) 354-2273

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35.094508
OH
208000000X
Pediatrics Physician
Primary
76750
GA
208000000X
Pediatrics Physician
E-10688
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
221871001
AR
Enumeration date
06/13/2007
Last updated
09/26/2019
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