Organization
SANDRA J LEWIS M.D. P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA J LEWIS MD (OWNER/PHYSICIAN)
(304) 926-0172
Entity
Organization
Contact information
Practice address
4004 MACCORKLE AVE SE, CHARLESTON, WV 25304-1672
(304) 926-0172
Mailing address
4004 MACCORKLE AVE SE, CHARLESTON, WV 25304-1672
(304) 926-0172
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
18980
WV
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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