Healthcare Provider Details

I. General information

NPI: 1588028492
Provider Name (Legal Business Name): ROBERT JOSEPH LEWIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
APO AE
09180-3100
US

IV. Provider business mailing address

BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL USA MEDDAC-KOREA, 549 HC/BDAACH, UNIT 15
APO AP
96271
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-7400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0101263213
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: