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General NPI Number Information
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NPI Number | 1699886937
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Entity Type | Individual
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Provider Name | MICHAEL R LEWIS MD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 4355 HICKORY BLVD UPPER SUITE
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City | GRANITE FALLS
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State | NC
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Zip | 28630-1992
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Country | US
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Telephone | 828-757-5060
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Fax | 828-757-5064
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Provider Business Mailing Address
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Address Line | 321 MULBERRY ST SW MEDICAL STAFF SERVICES
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City | LENOIR
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State | NC
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Zip | 28645-5720
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Country | US
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Telephone | 828-757-5965
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Fax | 828-757-5104
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30833
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License Number State | NC
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