Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 43010081467 | MI |
NPI | 1043429640 |
---|---|
Provider Name | Dr. Thomas Glenn Lewis |
First Address | Chillicothe, OH 45601-7202 |
Second Address | Chillicothe, OH 45601-7202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 30/12/2020 |