MEDICARE: MARVIN LEWIS 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	207Q00000X	Family Medicine Physician	33542	NC

Other Identifiers

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

General Provider Information

NPI Number	:	1861427825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARVIN LEWIS MD

Provider Business Mailing Address
First Line	:	40 AUTUMN FERN TRL
Second Line	:
City	:	LILLINGTON
State	:	NC
Zip	:	27546-5155
Country	:	US
Telephone Number	:	910-364-0971
Fax Number	:	910-814-4064

Provider Business Practice Location Address
First Line	:	6750 OVERHILLS RD
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-8872
Country	:	US
Telephone Number	:	910-436-2600
Fax Number	:	910-436-0588

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	09/08/2025

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