Healthcare Provider Details

I. General information

NPI: 1336343714
Provider Name (Legal Business Name): LEWIS DONALD HARTWELL L.P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MULL AVE
AKRON OH
44313-7502
US

IV. Provider business mailing address

900 MULL AVE
AKRON OH
44313-7502
US

V. Phone/Fax

Practice location:
  • Phone: 330-867-5603
  • Fax: 330-873-3439
Mailing address:
  • Phone: 330-867-5603
  • Fax: 330-873-3439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC0501210
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: