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Organization

KEVAN G LEWIS MD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVAN G LEWIS MD (OWNER)
(401) 525-8084
Entity
Organization

Contact information

Practice address
3879 E 120TH AVE, STE 238, THORNTON, CO 80233-1658
(401) 525-8084
Mailing address
3879 E 120TH AVE, STE 238, THORNTON, CO 80233-1658
(401) 525-8084

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
DR-45901
CO
207ND0101X
MOHS-Micrographic Surgery Physician
DR-45901
CO
207ND0900X
Dermatopathology Physician
DR-45901
CO
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
DR-45901
CO
207NP0225X
Pediatric Dermatology Physician
DR-45901
CO
207NS0135X
Procedural Dermatology Physician
DR-45901
CO
207ZD0900X
Dermatopathology (Pathology) Physician
DR-45901
CO

Other

Enumeration date
12/15/2008
Last updated
12/15/2008
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