Kevan G Lewis
Dermatologist MOHS-Micrographic Surgeon
3059 Voyager Dr
Green Bay
, Wisconsin 54311-8303
Kevan G Lewis
Dermatologist MOHS-Micrographic Surgeon
3059 Voyager Dr
Green Bay
, Wisconsin 54311-8303
(920) 273-6011
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About
Features
Specialties
- Dermatologist
- MOHS-Micrographic Surgeon
Languages spoken
- English
Location
First Address
- Kevan G Lewis
- 2221 S Webster Ave Ste 241
- Green Bay, WI
- Zip : 54301-2158
- Fax : (920) 273-6011
- Phone : (920) 965-0345
Second Address
- Kevan G Lewis
- 3059 Voyager Dr
- Green Bay, WI
- Zip : 54311-8303
- Fax : (920) 257-4559
- Phone : (920) 965-0345
Reviews
FAQs
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Is Kevan G Lewis accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207N00000X | Dermatologist | 51745 | MN |
| N | 207N00000X | Dermatologist | 53110-20 | WI |
| N | 207N00000X | Dermatologist | LP00514 | RI |
| Y | 207ND0101X | MOHS-Micrographic Surgeon | 53110-020 | WI |
National Provider Identifier
| NPI | 1497970560 |
|---|---|
| Provider Name | Kevan G Lewis |
| First Address | Green Bay, WI 54301-2158 |
| Second Address | Green Bay, WI 54311-8303 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/04/2007 |
| Last Update Date | 29/09/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1497970560 | (05) | WI |
| 53110-020 | STATE LICENSE (01) | WI |
| ENROLLED | (05) | IA |
| ENROLLED | (05) | MN |
| FL0601179 | DEA (01) | WI |
| P00787809 | RAILROAD MEDICARE (01) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.