Organization
DRS BRAD & ELAINE LEWIS MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW T WOLF BSBA (CONTRACT/CREDENTIALING MANAGER)
(740) 687-5164
Entity
Organization
Contact information
Practice address
1147 E MAIN ST, LANCASTER, OH 43130-4056
(740) 687-9173
(740) 689-3740
Mailing address
1147 E MAIN ST, LANCASTER, OH 43130-4056
(740) 687-9173
(740) 689-3740
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35056043
OH
207R00000X
Internal Medicine Physician
35059549
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2877730
—
OH
Enumeration date
01/25/2008
Last updated
10/09/2012
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