Individual
DR. JODY PARKS LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3001 LYNDHURST AVE, WINSTON SALEM, NC 27103
(336) 765-0383
(336) 760-6918
Mailing address
3001 LYNDHURST AVE, WINSTON SALEM, NC 27103-4007
(336) 765-0383
(336) 760-6918
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
90092
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2013-01227
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053571638
PARTNERS
NC
05
—
1053571638
—
NC
01
—
179R0
BCBS
NC
01
—
267246
MEDCOST
NC
01
—
3650930
UNITED HEALTHCARE
NC
01
—
5084978
AETNA
NC
01
—
Q27017
SC MEDICAID
SC
Enumeration date
06/17/2008
Last updated
03/25/2021
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