Individual
LAWRENCE A LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
629 N SANDUSKY AVE, BUCYRUS, OH 44820-1821
(419) 562-4677
(419) 862-0987
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35068697L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000246458
BCBS MARION
OH
01
—
000000316694
ANTHEM/BCBS
OH
01
—
000000384391
BCBS GALION
—
05
—
1080002
—
OH
01
—
930116138
RR MEDICARE MARION
OH
01
—
P00216224
MEDICARE RAIL ROAD/BUCYRUS
OH
01
—
P00320500
RR NMEDICARE
—
Enumeration date
04/25/2006
Last updated
06/26/2023
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