Provider Demographics
NPI:1104025535
Name:LEWIS, DEBORAH LYN (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYN
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 1:700 EXPOSITION PL
Mailing Address - Street 2:SUITE111
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-1560
Mailing Address - Country:US
Mailing Address - Phone:919-845-6133
Mailing Address - Fax:919-845-6149
Practice Address - Street 1:700 EXPOSITION PL
Practice Address - Street 2:SUITE111
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-1560
Practice Address - Country:US
Practice Address - Phone:919-845-6133
Practice Address - Fax:919-845-6149
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39843207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine