Individual
NATHANIEL DAVID LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
145 ROYAL DR, BRUNSWICK, GA 31523-6278
(912) 466-9279
Mailing address
145 ROYAL DR, BRUNSWICK, GA 31523
(912) 466-9279
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003667
GA
Other
Enumeration date
02/17/2006
Last updated
03/05/2008
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