Individual
JACK COVINGTON LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 WOODLAND RD, SALISBURY, MD 21801-6730
(410) 742-8679
Mailing address
1100 WOODLAND RD, SALISBURY, MD 21801-6730
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D0006783
MD
Other
Enumeration date
12/03/2011
Last updated
12/03/2011
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