Individual
SHAYE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
520 S EAGLE RD STE 3102, MERIDIAN, ID 83642-6352
(208) 706-5100
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-14215
ID
Other
Enumeration date
03/28/2015
Last updated
09/27/2022
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