MEDICARE: LEWIS HELLER 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	2083P0901X	Public Health & General Preventive Medicine Physician	14873	AZ

General Provider Information

NPI Number	:	1255652319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEWIS HELLER MD

Provider Business Mailing Address
First Line	:	11120 N TATUM BLVD
Second Line	:	SUITE 101
City	:	PHOENIX
State	:	AZ
Zip	:	85028-1628
Country	:	US
Telephone Number	:	602-502-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	11120 N TATUM BLVD
Second Line	:	SUITE 101
City	:	PHOENIX
State	:	AZ
Zip	:	85028-1628
Country	:	US
Telephone Number	:	602-502-4000
Fax Number	:

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

Provider Enumeration Date	:	06/11/2010
Last Update Date	:	06/11/2010

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