Provider Demographics
NPI:1801815782
Name:LEWIS, BARRY L (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:L
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 1:3027 CHESTNUT ST NW
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1407
Mailing Address - Country:US
Mailing Address - Phone:301-946-5100
Mailing Address - Fax:301-929-0348
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:301-946-5100
Practice Address - Fax:301-929-0348
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD30908207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010015537Medicaid
DC4383721OtherAETNA NON HMO
MD699734101Medicaid
DC035008400Medicaid
DC490537OtherNCPPO
DC0146OtherCAREFIRST BCBS
VA289539OtherANTHEM BCBS
DC240118OtherKAISER
DC3294140OtherAETNA HMO
DCP00056086Medicare ID - Type UnspecifiedRAILROAD MEDICARE
DC3294140OtherAETNA HMO
DC012391B13Medicare ID - Type UnspecifiedTRAILBLAZER MEDICARE