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General NPI Number Information
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NPI Number | 1407034895
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Entity Type | Individual
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Provider Name | RONALD FRANK LEWIS PHD
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Gender | Male
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 32270 TELEGRAPH SUITE 240 DAVID GUREVICH MD PC
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City | BINGHAM FARMS
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State | MI
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Zip | 48025
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Country | US
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Telephone | 248-835-6654
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Fax | 248-593-1711
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Provider Business Mailing Address
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Address Line | 19933 OLD POND COURT
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City | BEVERLY HILLS
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State | MI
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Zip | 48025
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Country | US
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Telephone | 248-835-6654
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Fax | 248-203-6416
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | L930686
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | L930686
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | L930686
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License Number State | MI
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