Provider Demographics
NPI:1174180277
Name:LEWIS, SERINA J (MD)
Entity Type:Individual
Prefix:DR
First Name:SERINA
Middle Name:J
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:3461 JACOBS FORD WAY
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-2502
Mailing Address - Country:US
Mailing Address - Phone:404-408-2911
Mailing Address - Fax:
Practice Address - Street 1:8600 SNOWDEN RIVER PKWY STE 207
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1985
Practice Address - Country:US
Practice Address - Phone:301-595-2901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-23
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0095042207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine