Individual
GREGORY P LEWANDOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(505) 662-9256
Mailing address
P.O. BOX 589, FORT DEFIANCE INDIAN HOSPITAL BOARD, INC., FT. DEFIANCE, AZ 86504-0649
(505) 685-4501
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R42821
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A1676
—
NM
01
—
NM006H10
NM BCBS
NM
Enumeration date
08/31/2006
Last updated
10/02/2014
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