Individual
LEWIS WILLIAM GRAVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
413 CARRIAGE DRIVE, BECKLEY, WV 25801-2805
(304) 253-1210
(304) 255-4040
Mailing address
413 CARRIAGE DRIVE, BECKLEY, WV 25801-2805
(304) 253-1210
(304) 255-4040
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
11494
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095205000
—
WV
Enumeration date
04/03/2006
Last updated
04/10/2008
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