MEDICARE: MS. BEVERLY ANN 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	207R00000X	Internal Medicine Physician	26559	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0185M51791	OTHER	NC	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831160399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BEVERLY ANN LEWIS MD

Provider Business Mailing Address
First Line	:	PO BOX 884
Second Line	:	405 MCCASKEY RD
City	:	WILLIAMSTON
State	:	NC
Zip	:	27892
Country	:	US
Telephone Number	:	252-792-6071
Fax Number	:	252-792-0889

Provider Business Practice Location Address
First Line	:	983 US HIGHWAY 64 E
Second Line	:
City	:	PLYMOUTH
State	:	NC
Zip	:	27962-9216
Country	:	US
Telephone Number	:	252-793-1010
Fax Number	:	252-793-4113

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	07/30/2012

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