Provider Demographics
NPI:1427212489
Name:MICHAEL R LEWIS,MD
Entity Type:Organization
Organization Name:MICHAEL R LEWIS,MD
Other - Org Name:HUDSON FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-728-4875
Mailing Address - Street 1:270 PINE MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28638-2634
Mailing Address - Country:US
Mailing Address - Phone:828-728-4875
Mailing Address - Fax:828-726-0438
Practice Address - Street 1:270 PINE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NC
Practice Address - Zip Code:28638-2634
Practice Address - Country:US
Practice Address - Phone:828-728-4875
Practice Address - Fax:828-726-0438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30833261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8957834Medicaid
NC8957834Medicaid
NCC58890Medicare UPIN