Provider Demographics
NPI:1497767529
Name:SLAWSKY, LEWIS DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:DAVID
Last Name:SLAWSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 SMITHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-6100
Mailing Address - Country:US
Mailing Address - Phone:865-380-9300
Mailing Address - Fax:865-380-1558
Practice Address - Street 1:615 SMITHVIEW DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-6100
Practice Address - Country:US
Practice Address - Phone:865-380-9300
Practice Address - Fax:865-380-1558
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000026250207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3144148OtherBCBS PROVIDER NUMBER
TN3091975Medicaid
TN4619423OtherAETNA PROVIDER NUMBER
TN3091975Medicare ID - Type Unspecified
TN3091975Medicaid