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Individual

MATTHEW WESLEY LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6300 E LAKE BLVD, SUITE 201, VANCLEAVE, MS 39565-6770
(228) 206-2263
(228) 206-1192
Mailing address
6300 E LAKE BLVD, VANCLEAVE, MS 39565-6770
(228) 206-2263
(228) 206-1192

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
23036
MS
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
23036
MS

Other

Enumeration date
06/11/2009
Last updated
03/22/2017
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