Individual
DR. JENNIFER MICHELLE LEWISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1223 S WASHINGTON, ROYAL OAK, MI 48067
(248) 399-9083
(248) 399-2417
Mailing address
1223 S WASHINGTON, ROYAL OAK, MI 48067
(248) 399-9083
(248) 399-2417
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301073287
MI
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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