Individual
CHANTAL D LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3122 GOLANSKY BLVD STE 101, WOODBRIDGE, VA 22192-4267
(571) 989-4134
(703) 774-3939
Mailing address
3122 GOLANSKY BLVD STE 101, WOODBRIDGE, VA 22192-4267
(571) 989-4134
(703) 774-3939
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101245466
VA
207Q00000X
Family Medicine Physician
D0069954
MD
207Q00000X
Family Medicine Physician
MD038499
DC
Other
Enumeration date
07/09/2008
Last updated
04/11/2020
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