Provider Demographics
NPI:1235100660
Name:LEWIS, CYNTHIA M (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2401
Mailing Address - Country:US
Mailing Address - Phone:308-865-2303
Mailing Address - Fax:308-865-2304
Practice Address - Street 1:412 W 42ND ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2401
Practice Address - Country:US
Practice Address - Phone:308-865-2303
Practice Address - Fax:308-865-2304
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18931207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025001100Medicaid
NE18931OtherNEBRASKA LICENSE #
NEG45075Medicare UPIN
NE18931OtherNEBRASKA LICENSE #