MEDICARE: MICHAEL JOSEPH REWIS II M.D.

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	207R00000X	Internal Medicine Physician	217827	NC

General Provider Information

NPI Number	:	1205298338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JOSEPH REWIS II M.D.

Provider Business Mailing Address
First Line	:	321 MULBERRY ST SW
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-5720
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	322 MULBERRY ST SW STE A
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-5703
Country	:	US
Telephone Number	:	828-757-6400
Fax Number	:	828-757-6424

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

Provider Enumeration Date	:	03/28/2016
Last Update Date	:	03/17/2021

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