Individual
DR. GARY S. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
136 N MAIN ST, SUITE 201, THIENSVILLE, WI 53092-1606
(262) 242-3369
(262) 242-3219
Mailing address
136 N MAIN ST, SUITE 201, THIENSVILLE, WI 53092-1606
(262) 242-3369
(262) 242-3219
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
330004-020
WI
207Q00000X
Family Medicine Physician
Primary
33004-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31823100
—
WI
Enumeration date
06/01/2006
Last updated
06/15/2016
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