MEDICARE: DR. SERINA J LEWIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D0095042	MD

General Provider Information

NPI Number	:	1174180277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SERINA J LEWIS MD

Provider Business Mailing Address
First Line	:	3461 JACOBS FORD WAY
Second Line	:
City	:	HANOVER
State	:	MD
Zip	:	21076-2502
Country	:	US
Telephone Number	:	404-408-2911
Fax Number	:

Provider Business Practice Location Address
First Line	:	8600 SNOWDEN RIVER PKWY STE 207
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-1985
Country	:	US
Telephone Number	:	301-595-2901
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2019
Last Update Date	:	08/14/2025

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