Provider Demographics
NPI:1790972933
Name:LEWIS, LINDA F (RDCS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:F
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 INTERCOASTAL DR APT 1304
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-8242
Mailing Address - Country:US
Mailing Address - Phone:910-734-8004
Mailing Address - Fax:
Practice Address - Street 1:4350 INTERCOASTAL DR APT 1304
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-8242
Practice Address - Country:US
Practice Address - Phone:910-734-8004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14222246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography