Individual
DR. LEWIS C HALVERSON
Active
Individual
DR. LEWIS C HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036078330
IL
2085R0202X
Diagnostic Radiology Physician
Primary
R1J93
MO
2085R0204X
Vascular & Interventional Radiology Physician
036078330
IL
2085R0204X
Vascular & Interventional Radiology Physician
R1J93
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078330
—
IL
05
—
202775904
—
MO
01
—
300102486
RAILROAD MEDICARE NUMBER
—
01
—
300102491
RAILROAD MEDICARE NUMBER
—
Enumeration date
07/09/2006
Last updated
11/10/2020
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