Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 0101238044 | VA |
NPI | 1003893694 |
---|---|
Provider Name | Andrew W Lewis |
First Address | Newport News, VA 23601-1318 |
Second Address | Newport News, VA 23606-4206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I40798 | (02) |