Provider Demographics
NPI:1609804491
Name:LEWIS, MATTHEW CRAIG (CSA)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:CRAIG
Last Name:LEWIS
Suffix:
Gender:M
Credentials:CSA
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Mailing Address - Street 1:8717 N 67TH DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-8415
Mailing Address - Country:US
Mailing Address - Phone:623-931-1992
Mailing Address - Fax:
Practice Address - Street 1:2852 S CARRIAGE LN
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-7801
Practice Address - Country:US
Practice Address - Phone:480-706-9430
Practice Address - Fax:480-461-1785
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical