MEDICARE: DR. LEWIS B CHAIKIN 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	208800000X	Urology Physician	ME35345	FL

General Provider Information

NPI Number	:	1326054131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEWIS B CHAIKIN M.D

Provider Business Mailing Address
First Line	:	4048 EVANS AVE STE 306
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9390
Country	:	US
Telephone Number	:	239-433-3323
Fax Number	:

Provider Business Practice Location Address
First Line	:	4048 EVANS AVE STE 306
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9390
Country	:	US
Telephone Number	:	239-433-3323
Fax Number	:	239-433-7757

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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