Healthcare Provider Details

I. General information

NPI: 1336038751
Provider Name (Legal Business Name): ARTHUR L LEWIS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1953 UNION AVE APT 3B
BENTON HARBOR MI
49022-6257
US

IV. Provider business mailing address

1953 UNION AVE APT 3B AJLEONNI6@GMAIL.COM
BENTON HARBOR MI
49022
US

V. Phone/Fax

Practice location:
  • Phone: 269-287-9933
  • Fax: 269-287-9933
Mailing address:
  • Phone: 269-392-3555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: