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NPI Code Detail

MEDICARE: DANA MARIE LEWIS D.O.

MEDICARE: DANA MARIE LEWIS D.O.
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
1207P00000XEmergency Medicine Physician100716WI
2207Q00000XFamily Medicine Physician53354CO
3207Q00000XFamily Medicine Physician20A7088CA
4207Q00000XFamily Medicine Physician93933SC

Other Identifiers

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

General Provider Information

NPI Number : 1396717013
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA MARIE LEWIS D.O.
Provider Business Mailing Address
First Line : PO BOX 604308
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-4308
Country : US
Telephone Number : 804-273-8014
Fax Number : 855-858-0464
Provider Business Practice Location Address
First Line : 3372 LAURENS RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-5236
Country : US
Telephone Number : 864-537-4600
Fax Number : 855-858-0464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 05/06/2025

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