Provider Demographics
NPI:1578511671
Name:LEWIS, MELINDA M (MD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:1365 CLIFTON RD NE
Mailing Address - Street 2:BUILDING A, ROOM A3503
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1013
Mailing Address - Country:US
Mailing Address - Phone:404-712-4448
Mailing Address - Fax:404-778-4860
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:BUILDING A, ROOM A3503
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-712-4448
Practice Address - Fax:404-778-4860
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2024-02-28
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Provider Licenses
StateLicense IDTaxonomies
GA027599207ZP0102X, 207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE72616Medicare UPIN