Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2009-00955 | NC |
N | 207XS0106X | Orthopaedic Hand Surgeon | 2009-00955 | NC |
NPI | 1235332024 |
---|---|
Provider Name | Dr. Daniel Robert Lewis |
First Address | Charlotte, NC 28209-3239 |
Second Address | Charlotte, NC 28207-1101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 12/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5911770 | (05) | NC |