Healthcare Provider Details

I. General information

NPI: 1518086131
Provider Name (Legal Business Name): AMY LEWIS D.AC., DIPL. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 K ST NW STE 375
WASHINGTON DC
20006-1679
US

IV. Provider business mailing address

12324 WOODWALK TER
BOWIE MD
20721-4206
US

V. Phone/Fax

Practice location:
  • Phone: 22-822-1711
  • Fax:
Mailing address:
  • Phone: 240-461-1384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU01364
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC500041
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: