Provider Demographics
NPI:1124018825
Name:LEWIS, MAURICE J (MD)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:J
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:890 POPLAR CHURCH RD
Mailing Address - Street 2:SUITE 508
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2250
Mailing Address - Country:US
Mailing Address - Phone:717-761-3875
Mailing Address - Fax:717-761-7893
Practice Address - Street 1:890 POPLAR CHURCH RD
Practice Address - Street 2:SUITE 508
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2250
Practice Address - Country:US
Practice Address - Phone:717-761-3875
Practice Address - Fax:717-761-7893
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2007-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA028418L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006518260001Medicaid
PAC27338Medicare UPIN
PA017705G7MMedicare PIN