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Individual

DR. MICHAEL C LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
655 W 8TH ST, ANESTHESIOLOGY, JACKSONVILLE, FL 32209-6511
(904) 244-4195
Mailing address
PO BOX 44008, PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3660
(904) 244-3425

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME62770
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003133873A
GA
05
0423777-01
FL
01
21066
BCBS
FL
Enumeration date
07/07/2006
Last updated
01/22/2014
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