Individual
DR. JOAN P LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5065 CORRALES RD, CORRALES, NM 87048-8629
(505) 404-8154
(505) 919-7061
Mailing address
PO BOX 2480, CORRALES, NM 87048-2480
(505) 404-8154
(505) 919-7061
Taxonomy
Speciality
Code
Description
License number
State
193200000X
Multi-Specialty Group
94-300
NM
208D00000X
General Practice Physician
Primary
94-300
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00021906
—
NM
Enumeration date
02/19/2007
Last updated
11/05/2020
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