Individual
MR. JEREMIAH P LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
12289 HANCOCK ST, STE 34, CARMEL, IN 46032-5801
(317) 815-8950
(317) 815-8951
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000791A
IN
Other
Enumeration date
09/18/2007
Last updated
12/07/2020
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