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NPI Code Detail

MEDICARE: CHAD LEWMAN

MEDICARE: CHAD LEWMAN
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
1175T00000XPeer SpecialistOK

Other Identifiers

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

General Provider Information

NPI Number : 1881358810
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAD LEWMAN
Provider Business Mailing Address
First Line : 1103 SE 15TH ST
Second Line :
City : WAGONER
State : OK
Zip : 74467-8101
Country : US
Telephone Number : 918-729-5558
Fax Number :
Provider Business Practice Location Address
First Line : 118 W KEETOOWAH ST
Second Line :
City : TAHLEQUAH
State : OK
Zip : 74464-3820
Country : US
Telephone Number : 918-729-5558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2021
Last Update Date : 10/26/2021

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Directions to “ CHAD LEWMAN ” Practice Location

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