Provider Demographics
NPI:1518114206
Name:LEWIS, RICHARD DONALD (BS, RRT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:DONALD
Last Name:LEWIS
Suffix:
Gender:M
Credentials:BS, RRT
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7618 WOODLEA ROAD WEST
Mailing Address - Street 2:
Mailing Address - City:OSCODA
Mailing Address - State:MI
Mailing Address - Zip Code:48750-8708
Mailing Address - Country:US
Mailing Address - Phone:989-747-0969
Mailing Address - Fax:
Practice Address - Street 1:7618 WOODLEA RD W
Practice Address - Street 2:
Practice Address - City:OSCODA
Practice Address - State:MI
Practice Address - Zip Code:48750-8708
Practice Address - Country:US
Practice Address - Phone:989-820-8969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI44014141227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI$$$$$$$$$OtherSSAN