Healthcare Provider Details

I. General information

NPI: 1831183672
Provider Name (Legal Business Name): STEVEN TEEFORD LEWIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 02/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 WESTWIND RD
MONETA VA
24121-3726
US

IV. Provider business mailing address

70 WESTWIND RD
MONETA VA
24121-3726
US

V. Phone/Fax

Practice location:
  • Phone: 540-721-7333
  • Fax: 540-721-4971
Mailing address:
  • Phone: 540-721-7333
  • Fax: 540-721-4971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101031990
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: