MEDICARE: CHRISTOPHER T LEWIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35082839L	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154388130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER T LEWIS MD

Provider Business Mailing Address
First Line	:	2830 VICTORY PARKWAY
Second Line	:	PAYOR ENROLLMENT
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1785
Country	:	US
Telephone Number	:	513-585-5507
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 BURNET AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3091
Country	:	US
Telephone Number	:	513-584-8600
Fax Number	:	513-585-9018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	03/21/2019

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