Provider Demographics
NPI:1922107002
Name:FERMAGLICH, LEWIS JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:JOSEPH
Last Name:FERMAGLICH
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 1:4128 LELAND ST
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5034
Mailing Address - Country:US
Mailing Address - Phone:202-321-0359
Mailing Address - Fax:
Practice Address - Street 1:6000 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3803
Practice Address - Country:US
Practice Address - Phone:301-881-7995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034924208000000X
IL336087718208000000X
MDD0075734208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics