Provider Demographics
NPI:1588841944
Name:LEWIS MEYERSON, MD, PC
Entity Type:Organization
Organization Name:LEWIS MEYERSON, MD, PC
Other - Org Name:MEYERSON MEDICAL AND PROFESSIONAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SUMNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-528-5281
Mailing Address - Street 1:104 SARAH ANN BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-0185
Mailing Address - Country:US
Mailing Address - Phone:636-528-5281
Mailing Address - Fax:636-462-2637
Practice Address - Street 1:104 SARAH ANN BOULEVARD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379-0185
Practice Address - Country:US
Practice Address - Phone:636-528-5281
Practice Address - Fax:636-462-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty