Provider Demographics
NPI:1225557069
Name:LEWIS, ADRIEAN A (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADRIEAN
Middle Name:A
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16521 GOVERNOR BRIDGE RD APT 308
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3669
Mailing Address - Country:US
Mailing Address - Phone:202-907-8774
Mailing Address - Fax:
Practice Address - Street 1:6920 LAUREL BOWIE RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1710
Practice Address - Country:US
Practice Address - Phone:301-262-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25164183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist