Individual
CHARLES LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
890 LAZELLE ST, STURGIS, SD 57785
(605) 720-2600
(605) 720-2611
Mailing address
353 FAIRMONT BLVD, ATTEN MEDICAL STAFF SERVICES, RAPID CITY, SD 57701-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1554
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00401797
RR MEDICARE
SD
Enumeration date
06/28/2006
Last updated
02/05/2013
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