Individual
COURTLAND G LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 SEYMOUR ST, SUITE 607, HARTFORD, CT 06106-5501
(860) 549-8232
(860) 247-3803
Mailing address
85 SEYMOUR ST, SUITE 607, HARTFORD, CT 06106-5501
(860) 549-8232
(860) 247-3803
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
026220
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001262203
—
CT
01
—
200000921
MEDICARE ID-PHYSICAN
CT
Enumeration date
07/07/2005
Last updated
06/22/2011
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