Individual
LEWIS A SIERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 N MAIN ST, FOND DU LAC, WI 54935-3423
(920) 926-8492
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
26876
WI
207R00000X
Internal Medicine Physician
Primary
26876
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13288
DEAN
WV
05
—
30649400
—
WI
01
—
930118899
RAILROAD MEDICARE
WI
Enumeration date
11/17/2005
Last updated
04/09/2010
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