Organization
BARRY K LEWIS DO PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY LEWIS MD (PRESIDENT)
(248) 320-1997
Entity
Organization
Contact information
Practice address
37799 PROFESSIONAL CENTER DR, SUITE 105, LIVONIA, MI 48154-1153
(734) 462-0340
Mailing address
PO BOX 252798, WEST BLOOMFIELD, MI 48325-2798
(734) 462-0340
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
5101007077
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5101007077
STATE LICENSE
MI
Enumeration date
12/29/2010
Last updated
12/29/2010
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