Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | MD464309 | PA |
N | 207RP1001X | Pulmonary Disease | MD464309 | PA |
N | 207RS0012X | Sleep Medicine | MD464309 | PA |
NPI | 1083909089 |
---|---|
Provider Name | Dr. O'dene Hanniffe Lewis |
First Address | Silver Spring, MD 20904 |
Second Address | Silver Spring, MD 20904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2011 |
Last Update Date | 30/07/2018 |