Individual
MICHELLE D LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3935 N. LIGHTNING DRIVE, APPLETON, WI 54913-7890
(920) 968-1790
(920) 968-1794
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 686-9674
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
53110-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53730-020
STATE LICENSE
WI
Enumeration date
07/31/2006
Last updated
08/12/2022
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