Individual
ADAM D LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2415 PARKWOOD DR, BRUNSWICK, GA 31520-4722
(919) 477-5152
(919) 477-5474
Mailing address
PO BOX 15386, DURHAM, NC 27704-0386
(919) 477-5152
(919) 477-5474
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
054586
GA
207P00000X
Emergency Medicine Physician
Primary
054586
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01064795
AMERIGROUP
GA
05
—
130862775C
—
GA
05
—
130862775D
—
GA
Enumeration date
02/22/2006
Last updated
05/27/2008
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