Provider Demographics
NPI:1194836791
Name:LEWIS, BRYAN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:CHRISTOPHER
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WELLNESS WAY STE A
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1768
Mailing Address - Country:US
Mailing Address - Phone:207-406-7600
Mailing Address - Fax:207-406-7601
Practice Address - Street 1:1 WELLNESS WAY STE A
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1768
Practice Address - Country:US
Practice Address - Phone:207-406-7600
Practice Address - Fax:207-406-7601
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41337207R00000X
NHT-0854207R00000X
NH17579207R00000X
NY311267-01207R00000X
MEMD25525207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN41337OtherMD STATE LICENSE