Individual
DR. RICHARD MARK LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
719 GREEN VALLEY RD STE 306, GREENSBORO, NC 27408-7026
(336) 275-6470
(336) 275-6474
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1779
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0475K
BCBS NC
NC
01
—
5441630
AETNA
NC
01
—
58893
MEDCOST
NC
Enumeration date
06/08/2006
Last updated
08/13/2021
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