Individual
DR. MICHAEL RAY LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 OLD PASS RD, GULFPORT, MS 39501-2585
(228) 865-7890
(228) 868-7402
Mailing address
4500 OLD PASS RD, GULFPORT, MS 39501-2585
(228) 865-7890
(228) 868-7402
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13326
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116618
—
MS
01
—
060065909
MEDICARE SECONDARY PAYOR
MS
Enumeration date
06/02/2006
Last updated
10/28/2009
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