Individual
MR. MICHAEL SHANNON LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
170 TAYLOR STATION RD, COLUMBUS, OH 43213-4441
(614) 851-7551
Mailing address
3583 ZINER CT, GROVE CITY, OH 43123-4815
(614) 394-4969
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
A0909042
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0059811
—
OH
Enumeration date
10/02/2009
Last updated
05/14/2013
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