Healthcare Provider Details

I. General information

NPI: 1134191422
Provider Name (Legal Business Name): LAWRENCE LEWANDOWSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUNSHINE HEALTH PROFESSIONALS 4601 S. DUPONT HIGHWAY, SUITE 2
DOVER DE
19901-6405
US

IV. Provider business mailing address

1602 NEWPORT GAP PIKE
WILMINGTON DE
19808-6208
US

V. Phone/Fax

Practice location:
  • Phone: 302-698-1100
  • Fax: 302-698-1187
Mailing address:
  • Phone: 302-633-5840
  • Fax: 302-633-5844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC1-0004870
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: