Healthcare Provider Details

I. General information

NPI: 1245210822
Provider Name (Legal Business Name): JAMES E LEWANDOWSKI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 10/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 W DIVISION ST
GRAND ISLAND NE
68801-6542
US

IV. Provider business mailing address

820 W DIVISION ST
GRAND ISLAND NE
68801-6542
US

V. Phone/Fax

Practice location:
  • Phone: 308-381-7262
  • Fax: 308-381-4672
Mailing address:
  • Phone: 308-381-7262
  • Fax: 308-381-4672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number230
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: