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Individual

RICHARD LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11649 N PORT WASHINGTON RD STE 114, MEQUON, WI 53092-3461
(262) 235-3800
(262) 236-9726
Mailing address
11649 N PORT WASHINGTON RD STE 114, MEQUON, WI 53092-3461
(262) 235-3800
(262) 236-9726

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36985
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32308200
WI
Enumeration date
02/09/2006
Last updated
04/10/2021
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