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NPI 1962200337

NPI 1962200337 : ANDREW WILLIAM LEWIS PA : ATLANTA, GA

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General NPI Number Information
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    NPI Number           |    1962200337
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREW WILLIAM LEWIS PA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/03/2025
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    Last Update Date     |    03/03/2025
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Provider Practice Location Address
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    Address Line         |    5665 NEW NORTHSIDE DR STE 320 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30328-5834
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    Country              |    US
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    Telephone            |    404-645-7645
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1717 DELLWOOD DR 
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    City                 |    GREENSBORO
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    State                |    NC
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    Zip                  |    27408-6321
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    Country              |    US
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    Telephone            |    336-420-7368
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    
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