Individual
MS. COLETTE E LEE-LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3025 SHRINE RD, STE 270, BRUNSWICK, GA 31520
(912) 262-2723
(877) 244-5666
Mailing address
3025 SHRINE RD, STE 270, BRUNSWICK, GA 31520
(912) 262-2723
(877) 244-5666
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
055783
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01035668
AMERIGROUP
GA
01
—
52043977
BLUE SHIELD
GA
05
—
630423104A
—
GA
01
—
P00215034
RILROAD MEDICARE
GA
Enumeration date
06/07/2007
Last updated
06/09/2021
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