Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 209462 | NY |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME97943 | FL |
NPI | 1932199643 |
---|---|
Provider Name | Dr. Ronald Lewis |
First Address | Summerville, SC 29485-8119 |
Second Address | Summerville, SC 29485 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 31/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01986676 | (05) | NY |
022347700 | (05) | FL |
205286 | (05) | AL |
H01367 | (02) | NY |