Provider Demographics
NPI:1619970274
Name:LEWIS, STEPHEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
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 1:10525 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4401
Mailing Address - Country:US
Mailing Address - Phone:513-745-9800
Mailing Address - Fax:513-985-2905
Practice Address - Street 1:10525 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4401
Practice Address - Country:US
Practice Address - Phone:513-745-9800
Practice Address - Fax:513-985-2905
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070338L207RC0000X, 207RI0011X
OH35-070338207RH0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RH0005XAllopathic & Osteopathic PhysiciansInternal MedicineHypertension Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0382429Medicaid
OHE52053Medicare UPIN
OH0382429Medicaid
OHLE0809165Medicare PIN
OH0809169Medicare PIN
OHLE809161Medicare PIN
OH060058968Medicare PIN