Provider Demographics
NPI:1114183381
Name:LEWIS, MICHAEL BRAM (DPT)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRAM
Last Name:LEWIS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4544 COLUMBUS ST
Mailing Address - Street 2:SUITE 1401
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6749
Mailing Address - Country:US
Mailing Address - Phone:716-907-9386
Mailing Address - Fax:
Practice Address - Street 1:4544 COLUMBUS ST
Practice Address - Street 2:SUITE 1401
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6749
Practice Address - Country:US
Practice Address - Phone:716-907-9386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist