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Organization

JENNIFER M. LEWISTON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JENNIFER MICHELLE LEWISTON M.D. (MEDICAL DOCTOR)
(248) 709-1177
Entity
Organization

Contact information

Practice address
42536 HAYES RD STE 100, CLINTON TWP, MI 48038-3644
(586) 286-9644
Mailing address
42536 HAYES RD STE 100, CLINTON TWP, MI 48038-3644
(586) 286-9644

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
07/02/2009
Last updated
07/02/2009
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