Healthcare Provider Details

I. General information

NPI: 1073897716
Provider Name (Legal Business Name): COMPREHENSIVE PAIN CONSULTANTS OF THE CAROLINAS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 06/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 GLEN COVE DR
ARDEN NC
28704-3219
US

IV. Provider business mailing address

PO BOX 254
SKYLAND NC
28776
US

V. Phone/Fax

Practice location:
  • Phone: 941-753-5918
  • Fax: 941-753-5964
Mailing address:
  • Phone: 828-708-9876
  • Fax: 828-687-7858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number200300171
License Number StateNC

VIII. Authorized Official

Name: DR. EDWARD A LEWIS
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 713-927-7607