Individual
CHAD EDWARD LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
17007 GA-67, STATESBORO, GA 30458
(912) 681-2500
Mailing address
17007 GA-67, STATESBORO, GA 30458
(912) 681-2500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1573
GA
363AM0700X
Medical Physician Assistant
MA064638
PA
363AS0400X
Surgical Physician Assistant
Primary
5094
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
903741496E
—
GA
Enumeration date
07/05/2007
Last updated
03/31/2025
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