Provider Demographics
NPI:1841582905
Name:LEWIS, ADRIAN P (MD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:P
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 1:4410 W NEWBERRY RD STE A3
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2290
Mailing Address - Country:US
Mailing Address - Phone:352-374-2818
Mailing Address - Fax:
Practice Address - Street 1:4410 W NEWBERRY RD STE A3
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2290
Practice Address - Country:US
Practice Address - Phone:352-374-2818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38882207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine