MEDICARE: LEWIS BROWN HARDEN M.D.

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	29150	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	170506	OTHER	IA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1407839525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEWIS BROWN HARDEN M.D.

Provider Business Mailing Address
First Line	:	BUILDING 0221
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50614-0001
Country	:	US
Telephone Number	:	319-273-2009
Fax Number	:	319-273-7030

Provider Business Practice Location Address
First Line	:	BUILDING 0221
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50614-0001
Country	:	US
Telephone Number	:	319-273-2009
Fax Number	:	319-273-7030

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	07/09/2007

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