Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0207X | Pediatric Hematology-Oncologist | 11137 | RI |
N | 2080P0207X | Pediatric Hematology-Oncologist | 13152 | ME |
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD2017-0771 | NM |
NPI | 1154369981 |
---|---|
Provider Name | Sam W Lew |
First Address | Silver City, NM 88061-7287 |
Second Address | Silver City, NM 88061-7287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 25/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7010584 | (05) | RI |
F20884 | (02) | RI |