Individual
DONALD JOEL LEWIS-KRAITSIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
516 E. NIZHONI BLVD., GALLUP, NM 87301-5748
(505) 722-1000
(505) 726-8740
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15870
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000 Q6196
—
NM
01
—
252726
AHCCCS
AZ
Enumeration date
11/03/2006
Last updated
03/01/2017
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