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Individual

DR. PHILIP A LEWALSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4201 SAINT ANTOINE ST, SUITE 3R, DETROIT, MI 48201-2153
(313) 745-3000
Mailing address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301054452
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301054452
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103309490
MI
05
104465687
MI
01
PL054452
BC/BS OF MICHIGAN
MI
Enumeration date
06/09/2006
Last updated
03/26/2019
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