Healthcare Provider Details

I. General information

NPI: 1831298066
Provider Name (Legal Business Name): IRVIN LEWIN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8280 MONTGOMERY RD STE 103
CINCINNATI OH
45236-6101
US

IV. Provider business mailing address

9443 READING RD
CINCINNATI OH
45215-3550
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-1911
  • Fax: 513-984-1912
Mailing address:
  • Phone: 513-563-2225
  • Fax: 513-563-2527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36002301
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: