Healthcare Provider Details

I. General information

NPI: 1952365728
Provider Name (Legal Business Name): RUBEN F LEWIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4931 S 27TH ST STE 400
GREENFIELD WI
53221
US

IV. Provider business mailing address

4931 S 27TH ST STE 400
GREENFIELD WI
53221-2652
US

V. Phone/Fax

Practice location:
  • Phone: 414-672-7200
  • Fax: 414-672-7400
Mailing address:
  • Phone: 414-672-7200
  • Fax: 414-672-7400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number28898020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: