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Individual

REGINALD D LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
5435 FELTL RD, MINNETONKA, MN 55343-7983
(952) 835-9880
(952) 857-1554
Mailing address
1959 NE PACIFIC ST, BOX 356174, SEATTLE, WA 98195-0001
(206) 598-5672

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.005279
IL
363A00000X
Physician Assistant
Primary
12450
MN
363A00000X
Physician Assistant
PA10005271
WA
363AS0400X
Surgical Physician Assistant
PA01229
OR

Other

Enumeration date
05/10/2007
Last updated
03/17/2018
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