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NPI Code Detail

MEDICARE: DR. ALAN G LEWANDOWSKI PHD

MEDICARE: DR. ALAN G LEWANDOWSKI PHD
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
1103G00000XClinical Neuropsychologist6301006435MI
2103TC0700XClinical Psychologist6301006435MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10C96409OTHERMIBCBS,
26130337OTHERMIPHP

General Provider Information

NPI Number : 1780634758
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALAN G LEWANDOWSKI PHD
Provider Business Mailing Address
First Line : 4328 W MICHIGAN AVE
Second Line :
City : KALAMAZOO
State : MI
Zip : 49006-5823
Country : US
Telephone Number : 269-375-2222
Fax Number :
Provider Business Practice Location Address
First Line : 4328 W MICHIGAN AVE
Second Line :
City : KALAMAZOO
State : MI
Zip : 49006-5823
Country : US
Telephone Number : 269-375-2222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 09/11/2025

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