Healthcare Provider Details

I. General information

NPI: 1437093382
Provider Name (Legal Business Name): LAUREN LEWINSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 DEERWOOD LN
STONE MOUNTAIN GA
30087-5330
US

IV. Provider business mailing address

616 DEERWOOD LN
STONE MOUNTAIN GA
30087-5330
US

V. Phone/Fax

Practice location:
  • Phone: 678-485-2785
  • Fax:
Mailing address:
  • Phone: 678-485-2785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: