Individual
DR. STASHA S LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3723 W 12600 S STE 150, RIVERTON, UT 84065-7296
(801) 285-4561
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 285-4561
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10122609-1205
UT
208000000X
Pediatrics Physician
51747
MN
208000000X
Pediatrics Physician
M6258
TX
Other
Enumeration date
05/25/2007
Last updated
01/19/2017
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