Individual
MARY JO LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2400 32ND AVE S, FARGO, ND 58103-5800
(701) 234-8820
(701) 234-8918
Mailing address
2400 32ND AVE S, FARGO, ND 58103-5800
(701) 234-8820
(701) 234-8918
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27159
MN
207R00000X
Internal Medicine Physician
4750
ND
Other
Enumeration date
07/07/2006
Last updated
12/02/2011
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