Healthcare Provider Details

I. General information

NPI: 1063669158
Provider Name (Legal Business Name): JOSHUA LEWIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 W BASELINE RD # 182-4466
PHOENIX AZ
85041-6574
US

IV. Provider business mailing address

2030 W BASELINE RD # 182-4466
PHOENIX AZ
85041-6574
US

V. Phone/Fax

Practice location:
  • Phone: 480-637-3305
  • Fax:
Mailing address:
  • Phone: 480-637-3305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number40474
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number27406
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: