Healthcare Provider Details

I. General information

NPI: 1427005735
Provider Name (Legal Business Name): STEVEN CRAIG LEWIS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 09/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

857 MONTGOMERY AVE
NARBERTH PA
19072-1541
US

IV. Provider business mailing address

857 MONTGOMERY AVE
NARBERTH PA
19072-1541
US

V. Phone/Fax

Practice location:
  • Phone: 610-664-2951
  • Fax: 610-664-2131
Mailing address:
  • Phone: 610-664-2951
  • Fax: 610-664-2131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberOS009361L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberOS009361L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: