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Organization

NEW DERMATOLOGY GROUP LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEVAN G LEWIS MD (OWNER)
(920) 965-0345
Entity
Organization

Contact information

Practice address
2360 DUCK CREEK PKWY, HOWARD, WI 54303-3300
(920) 965-0345
Mailing address
3059 VOYAGER DR, GREEN BAY, WI 54311-8303
(920) 965-0345
(920) 273-6011

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207ND0900X
Dermatopathology Physician
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
207NP0225X
Pediatric Dermatology Physician
207NS0135X
Procedural Dermatology Physician

Other

Enumeration date
10/02/2012
Last updated
07/28/2026
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