Individual
JEREMY J. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2211 LOMAS BLVD NE, UNMH, ALBUQUERQUE, NM 87106-2719
(505) 272-3247
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3247
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD2014-0073
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0026534
INSTITUTIONAL PERMIT
—
Enumeration date
06/13/2007
Last updated
04/12/2022
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