Provider Demographics
NPI:1669446605
Name:LEWINSTEIN, CHARLES J (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:J
Last Name:LEWINSTEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1838 AMERICAN WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6611
Mailing Address - Country:US
Mailing Address - Phone:770-995-7622
Mailing Address - Fax:770-995-7854
Practice Address - Street 1:5671 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 250
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-5000
Practice Address - Country:US
Practice Address - Phone:404-256-0170
Practice Address - Fax:404-256-2998
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2011-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA359312086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000509022OMedicaid
GAP00030542OtherRR MCE
GAP00030542OtherRR MCE
GA000509022OMedicaid