MEDICARE: DEON LEWIS

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1336951409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEON LEWIS

Provider Business Mailing Address
First Line	:	16771 WINTHROP ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-3623
Country	:	US
Telephone Number	:	947-517-4068
Fax Number	:

Provider Business Practice Location Address
First Line	:	16771 WINTHROP ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-3623
Country	:	US
Telephone Number	:	947-517-4068
Fax Number	:

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

Provider Enumeration Date	:	01/24/2025
Last Update Date	:	01/24/2025

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Directions to “ DEON LEWIS ” Practice Location

Language	Start Address	Practice Location

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