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General NPI Number Information
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NPI Number | 1083696397
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Entity Type | Individual
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Provider Name | VIDA MCGHEE-LEWIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 04/18/2014
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Provider Practice Location Address
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Address Line | 9006 INDIANAPOLIS BLVD
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City | HIGHLAND
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State | IN
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Zip | 46322-2501
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Country | US
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Telephone | 219-923-2241
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Fax | 219-838-3455
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Provider Business Mailing Address
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Address Line | 9201 CALUMET AVE
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City | MUNSTER
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State | IN
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Zip | 46321-2807
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Country | US
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Telephone | 219-836-2022
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Fax | 219-836-0034
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 01057105A
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License Number State | IN
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