Provider Demographics
NPI:1609194695
Name:LEWIS, CAMERON PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:PATRICK
Last Name:LEWIS
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:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-245-7010
Mailing Address - Fax:540-245-7011
Practice Address - Street 1:70 MEDICAL CENTER CIR STE 211
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2273
Practice Address - Country:US
Practice Address - Phone:540-245-7010
Practice Address - Fax:540-245-7011
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY279427207Y00000X
VA0101273467207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04109679Medicaid
NY04109679Medicaid