Provider Demographics
NPI:1275900482
Name:CHRISTINE P. LEWIS, PC
Entity Type:Organization
Organization Name:CHRISTINE P. LEWIS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-291-2367
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:FUNKSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21734-0489
Mailing Address - Country:US
Mailing Address - Phone:240-291-2367
Mailing Address - Fax:301-665-4587
Practice Address - Street 1:11236 ROBINWOOD DR
Practice Address - Street 2:SUITE 102
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6708
Practice Address - Country:US
Practice Address - Phone:240-291-2367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty