Individual
MS. STEPHANIE M LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1929 MASON DIXON HWY, MAIDSVILLE, WV 26541-8152
(304) 879-5020
(304) 879-4105
Mailing address
1929 MASON DIXON HWY, CORE, WV 26541
(304) 879-5020
(304) 879-4105
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
TX
363AM0700X
Medical Physician Assistant
Primary
01676
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D0177663
DPS
TX
Enumeration date
12/13/2010
Last updated
03/07/2023
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