Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 230 | NE |
NPI | 1245210822 |
---|---|
Provider Name | James E Lewandowski |
First Address | Grand Island, NE 68801-6542 |
Second Address | Grand Island, NE 68801-6542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 31/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02532 | BCBS (01) | NE |
U31640 | (02) | NE |