Individual
WALTER J LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14537 W INDIAN SCHOOL RD, #700, GOODYEAR, AZ 85395-9243
(623) 935-0247
(623) 974-9351
Mailing address
13943 N 91 AVENUE, C-101, PEORIA, AZ 85381-3629
(623) 760-9449
(623) 974-9351
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
40648
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013044999
BLUE CROSS BLUE SHIELD
AZ
01
—
1081859
UNITED HEALTHCARE
AZ
01
—
40648
STATE LICENSE
AZ
01
—
4Z2980
HEALTH NET
AZ
01
—
608299
AHCCCS
AZ
05
—
608299
—
AZ
01
—
P00725809
RAILROAD MEDICARE
AZ
Enumeration date
02/27/2007
Last updated
10/04/2013
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