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General NPI Number Information
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NPI Number | 1497755730
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Entity Type | Individual
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Provider Name | JED STEVEN LEWIS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 EMANCIPATION DR HAMPTON VA MEDICAL CENTER
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City | HAMPTON
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State | VA
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Zip | 23667-0001
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Country | US
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Telephone | 757-722-9961
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Fax |
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Provider Business Mailing Address
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Address Line | 4936 BURNLEY DR
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-8802
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Country | US
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Telephone | 757-259-0685
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 0202006397
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License Number State | VA
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