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General NPI Number Information
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NPI Number | 1093738809
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Entity Type | Individual
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Provider Name | SANDRA ELOISE LEWIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 19TH ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1927
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Country | US
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Telephone | 205-933-8101
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Fax | 205-558-4812
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Provider Business Mailing Address
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Address Line | 1389 ATKINS TRIMM BLVD
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City | HOOVER
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State | AL
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Zip | 35226-2016
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Country | US
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Telephone | 205-822-0934
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Fax |
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 4313
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License Number State | AL
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