Individual
DR. KERRY RANDALL LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10560 MAIN ST, SUITE 210, FAIRFAX, VA 22030-7182
(703) 273-3613
(703) 273-9676
Mailing address
10560 MAIN ST, SUITE 210, FAIRFAX, VA 22030-7182
(703) 273-3613
(703) 273-9676
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101028949
VA
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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