=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801815782
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARRY L LEWIS MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2006
-----------------------------------------------------
Last Update Date | 12/02/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 IRVING ST NW
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20010-2976
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-946-5100
-----------------------------------------------------
Fax | 301-929-0348
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3027 CHESTNUT ST NW SUITE 206
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20015-1407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-946-5100
-----------------------------------------------------
Fax | 301-929-0348
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | MD30908
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------