Individual
VIDA MCGHEE-LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9006 INDIANAPOLIS BLVD, HIGHLAND, IN 46322-2501
(219) 923-2241
(219) 838-3455
Mailing address
9201 CALUMET AVE, MUNSTER, IN 46321-2807
(219) 836-2022
(219) 836-0034
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01057105A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200473010
—
IN
01
—
M00075599
MEDICARE INDIVIDUAL PTAN
IN
Enumeration date
11/14/2005
Last updated
04/18/2014
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