Individual
KYLE MICHEAL LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 MICHIGAN ST NE, SUITE 2200, GRAND RAPIDS, MI 49503-2515
(616) 391-3245
(616) 391-3130
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 245-3107
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301101548
MI
Other
Enumeration date
06/26/2012
Last updated
02/20/2018
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