Provider Demographics
NPI:1659614212
Name:LEWIS, STEVEN J (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
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 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:804-228-1143
Mailing Address - Fax:804-228-7382
Practice Address - Street 1:1712 E BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-6930
Practice Address - Country:US
Practice Address - Phone:804-344-9848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101260742207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1659614212OtherANTHEM BC/BS
VA1659614212OtherCIGNA
VA1659614212OtherUSA MANAGED CARE
VA1659614212OtherVIRGINIA PREMIER HEALTH PLAN
VA1659614212OtherUNITED HEALTHCARE
VA1659614212OtherMULTIPLAN
VA1659614212Medicaid
VA1659614212OtherOPTIMA HEALTH
VA1659614212OtherHUMANA
NC1659614212Medicaid
VA1659614212OtherCORVEL
VA1659614212OtherTRICARE/CHAMPUS
VA1659614212OtherVIRGINIA HEALTH NETWORK
VA1659614212OtherCOVENTRY HEALTH CARE
VA1659614212OtherAETNA
VA1659614212OtherCORVEL