Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD175931 | OR |
NPI | 1033435672 |
---|---|
Provider Name | Dr. Matthew William Lewis |
First Address | Portland, OR 97219-4998 |
Second Address | Eugene, OR 97401-8176 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2010 |
Last Update Date | 27/09/2016 |