Provider Demographics
NPI:1588852909
Name:JAMES E LEWANDOWSKI DPM
Entity Type:Organization
Organization Name:JAMES E LEWANDOWSKI DPM
Other - Org Name:MID NEBRASKA FOOT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEWANDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:308-381-7262
Mailing Address - Street 1:820 W DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-6542
Mailing Address - Country:US
Mailing Address - Phone:308-381-7262
Mailing Address - Fax:308-381-4672
Practice Address - Street 1:820 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-6542
Practice Address - Country:US
Practice Address - Phone:308-381-7262
Practice Address - Fax:308-381-4672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2012-10-08
Deactivation Date:2007-11-09
Deactivation Code:
Reactivation Date:2008-01-02
Provider Licenses
StateLicense IDTaxonomies
NE230213ES0131X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0813420001Medicare NSC