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General NPI Number Information
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NPI Number | 1659408029
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Entity Type | Organization
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Legal Business Name | LEWIS & MCCORRY PC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 3863 LAKE MICHIGAN DR NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49534-4520
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Country | US
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Telephone | 616-453-2429
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Fax | 616-453-8340
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Provider Business Mailing Address
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Address Line | 3863 LAKE MICHIGAN DR NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49534-4520
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Country | US
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Telephone | 616-453-2429
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Fax | 616-453-8340
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Authorized Official
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Title or Position | MEMBER
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Name | DR. LEONARD A LEWIS JR.
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Credential | DO
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Telephone | 616-453-2429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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