Healthcare Provider Details

I. General information

NPI: 1043233299
Provider Name (Legal Business Name): EDWARD ALAN LEWIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N JUSTICE ST
HENDERSONVILLE NC
28791-3410
US

IV. Provider business mailing address

PO BOX 254
SKYLAND NC
28776-0254
US

V. Phone/Fax

Practice location:
  • Phone: 828-694-4548
  • Fax: 828-694-4547
Mailing address:
  • Phone: 828-708-9876
  • Fax: 828-687-7858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number200300171
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number200300171
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number200300171
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: