Provider Demographics
NPI:1093828931
Name:LEWIS, SHERRY ANN (MD)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:ANN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 MAX LUTHER DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35810-3801
Mailing Address - Country:US
Mailing Address - Phone:256-859-6340
Mailing Address - Fax:256-851-7475
Practice Address - Street 1:2005 MAX LUTHER DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-3801
Practice Address - Country:US
Practice Address - Phone:256-859-6340
Practice Address - Fax:256-851-7475
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00004494207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL16510LEWOtherBCBS PROVIDER NUMBER
AL16510LEWOtherBCBS PROVIDER NUMBER