Provider Demographics
NPI:1255650727
Name:LEWIS, PHILIP G (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:G
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:605 FLORAL VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5528
Mailing Address - Country:US
Mailing Address - Phone:215-968-1020
Mailing Address - Fax:215-968-1051
Practice Address - Street 1:605 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5528
Practice Address - Country:US
Practice Address - Phone:215-968-1020
Practice Address - Fax:215-968-1051
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD030924E2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine