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Individual

DR. CHARLES ALAN LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1224 OCALA RD, TALLAHASSEE, FL 32304-1548
(850) 576-2129
(850) 576-9602
Mailing address
602 RIVERVIEW DR, CARRABELLE, FL 32322-5053
(850) 697-4436

Taxonomy

Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
ME0057039
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
056965800
FL
01
080157777
RAILROAD (MEDICARE)
FL
Enumeration date
07/20/2006
Last updated
07/26/2015
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