Healthcare Provider Details

I. General information

NPI: 1619970274
Provider Name (Legal Business Name): STEPHEN J LEWIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10506A MONTGOMERY RD STE 301
CINCINNATI OH
45242-4401
US

IV. Provider business mailing address

10506A MONTGOMERY RD STE 301
CINCINNATI OH
45242-4401
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2400
  • Fax: 513-985-2905
Mailing address:
  • Phone: 513-246-2400
  • Fax: 513-985-2905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0005X
TaxonomyHypertension Specialist Physician
License Number35-070338
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35070338L
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35070338L
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: