Individual
FRED H. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
535 MAIN ST, OLEAN, NY 14760-1500
(716) 372-0141
(716) 376-2451
Mailing address
535 MAIN ST, OLEAN, NY 14760-1500
(716) 372-0141
(716) 376-2451
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
131715
NY
2080P0201X
Pediatric Allergy/Immunology Physician
131715
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010264202
UNIVERA
—
01
—
000500015002
BC/BS
—
05
—
00762327
—
NY
01
—
0206516
IHA
—
01
—
040426004096
FIDELIS
—
Enumeration date
07/19/2005
Last updated
02/16/2012
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