Individual
DR. LEWIS REISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 KINGS HWY, SUITE 101, SHREVEPORT, LA 71103
(318) 675-8631
(318) 675-8634
Mailing address
1512 W. KIRBY PLACE, SHREVEPORT, LA 71103
(318) 675-4881
(318) 675-7531
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.202441
LA
2080P0210X
Pediatric Nephrology Physician
202441
LA
2080P0210X
Pediatric Nephrology Physician
MA62698
NJ
2080P0210X
Pediatric Nephrology Physician
MD.202441
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1330698
—
LA
05
—
6911307
—
NJ
Enumeration date
10/26/2006
Last updated
05/12/2011
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