Individual
DR. ROGER A LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
603B W STATE AVE, TERRA ALTA, WV 26764-1223
(304) 789-2457
(304) 789-6812
Mailing address
603B W STATE AVE, TERRA ALTA, WV 26764-1223
(304) 789-2457
(304) 789-6812
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
WV12705
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056529000
—
WV
01
—
CM7276
MEDICARE RAILROAD
WV
Enumeration date
05/06/2006
Last updated
07/08/2013
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