Healthcare Provider Details

I. General information

NPI: 1316968142
Provider Name (Legal Business Name): LEWIS R. FIRST M.D., M.S., FAAP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 10/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GIVEN COURTYARD S 250
BURLINGTON VT
05405-0001
US

IV. Provider business mailing address

GIVEN COURTYARD S 250
BURLINGTON VT
05405-0001
US

V. Phone/Fax

Practice location:
  • Phone: 802-656-0027
  • Fax: 802-656-2077
Mailing address:
  • Phone: 802-656-0027
  • Fax: 802-656-2077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number(#042-0008978)
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: