Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 19408 | AZ |
N | 207R00000X | Internist | 19408 | AZ |
N | 111NI0900X | Internist | 19408 | AZ |
N | 207RA0201X | Internist - Allergy & Immunology | 32268 | MN |
NPI | 1619952009 |
---|---|
Provider Name | Dr. John Christopher Lewis |
First Address | Scottsdale, AZ 85259-5404 |
Second Address | Scottsdale, AZ 85259-5404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 08/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E52550 | (02) |