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General NPI Number Information
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NPI Number | 1407837412
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Entity Type | Individual
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Provider Name | ROBERT D. LEWIS M.D. LLC
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 4139 BOARDMAN CANFIELD RD SUITE 2
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City | CANFIELD
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State | OH
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Zip | 44406-9034
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Country | US
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Telephone | 330-533-6999
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Fax | 330-533-5498
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Provider Business Mailing Address
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Address Line | 4139 BOARDMAN CANFIELD RD SUITE 2
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City | CANFIELD
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State | OH
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Zip | 44406-9034
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Country | US
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Telephone | 330-967-4224
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Fax | 330-967-4226
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 61575
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License Number State | OH
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