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General NPI Number Information
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NPI Number | 1609230481
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Entity Type | Individual
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Provider Name | KIMBERLY DENISE LEWIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 200 HAWTHORNE LN
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City | CHARLOTTE
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State | NC
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Zip | 28204
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Country | US
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Telephone | 704-384-4021
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Fax | 704-384-5601
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Provider Business Mailing Address
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Address Line | 7204 AMBERHOUSE DR
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City | CHARLOTTE
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State | NC
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Zip | 28212-0335
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Country | US
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Telephone | 704-384-4021
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Fax | 704-384-5601
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2019-01124
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2019-01124
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 218386
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License Number State | NC
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