Individual
DR. DONALD R LEWELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4801 EXPO DR, MANITOWOC, WI 54220-9341
(920) 684-4429
(920) 684-6892
Mailing address
PO BOX 1900, MANITOWOC, WI 54221-1900
(920) 684-4429
(920) 684-6892
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
27021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037664001
ADMINASTAR FEDERAL
WI
05
—
30675000
—
WI
Enumeration date
08/09/2005
Last updated
02/25/2010
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