Healthcare Provider Details

I. General information

NPI: 1851534390
Provider Name (Legal Business Name): CHANDANI MARIA LEWIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 NAVARRE AVE
OREGON OH
43616-3207
US

IV. Provider business mailing address

2600 NAVARRE AVE
OREGON OH
43616-3207
US

V. Phone/Fax

Practice location:
  • Phone: 419-696-8882
  • Fax: 419-696-8819
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.120609
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: