Organization
MICHAEL R. LEWIS, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R LEWIS M.D. (PRESIDENT)
(228) 865-7890
Entity
Organization
Contact information
Practice address
4500 OLD PASS RD, GULFPORT, MS 39501-2585
(228) 865-7890
Mailing address
4500 OLD PASS RD, GULFPORT, MS 39501-2585
(228) 865-7890
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
13326
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568409878
INDIVIDUAL NPI
MS
Enumeration date
10/07/2008
Last updated
10/21/2010
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