Provider Demographics
NPI:1922182625
Name:LEWANDOWSKI, MARIE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:ANN
Last Name:LEWANDOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2325 OCEAN AVE # 1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-2605
Mailing Address - Country:US
Mailing Address - Phone:415-452-2000
Mailing Address - Fax:415-452-2001
Practice Address - Street 1:2325 OCEAN AVE # 1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-2605
Practice Address - Country:US
Practice Address - Phone:415-452-2000
Practice Address - Fax:415-452-2001
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA050133207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A501330Medicare PIN