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NPI Code Detail

MEDICARE: LEWIS B HOLMES MD

MEDICARE: LEWIS B HOLMES 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
1207Q00000XFamily Medicine Physician0420009507VT
2207Q00000XFamily Medicine PhysicianMD23696ME

General Provider Information

NPI Number : 1649269184
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEWIS B HOLMES MD
Provider Business Mailing Address
First Line : PO BOX 9746
Second Line :
City : PORTLAND
State : ME
Zip : 04104-5040
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 331 VERANDA ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-5545
Country : US
Telephone Number : 207-828-2402
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 09/30/2020

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Directions to “ LEWIS B HOLMES MD” Practice Location

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