Individual
MR. BRYAN DAVID LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1003 12TH ST, BUTNER, NC 27509-1626
(919) 575-7643
Mailing address
115 WENONAH WAY, DURHAM, NC 27713-2461
(919) 321-2023
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104121
NC
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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