Provider Demographics
NPI:1043233299
Name:LEWIS, EDWARD ALAN (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:ALAN
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:
Mailing Address - City:SKYLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28776-0254
Mailing Address - Country:US
Mailing Address - Phone:828-708-9876
Mailing Address - Fax:828-687-7858
Practice Address - Street 1:800 N JUSTICE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3410
Practice Address - Country:US
Practice Address - Phone:828-694-4548
Practice Address - Fax:828-694-4547
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300171207LP2900X, 208VP0014X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC133WGOtherBCBS NC
NC2012771EOtherMEDICARE PTAN
NC89133WGMedicaid
NCP00946479OtherRR MEDICARE
NC89013KEMedicaid
NC89133WGMedicaid