Provider Demographics
NPI:1750362216
Name:LEWANDOWSKI, ERIC (DO)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:LEWANDOWSKI
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 PATIENT CARE DR STE A
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4271
Mailing Address - Country:US
Mailing Address - Phone:517-374-7600
Mailing Address - Fax:885-480-9150
Practice Address - Street 1:3955 PATIENT CARE DR STE A
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4271
Practice Address - Country:US
Practice Address - Phone:517-374-7600
Practice Address - Fax:885-480-9150
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101014197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080D410020OtherBLUE CARE NETWORK
MI1009245OtherMCLAREN HEALTH PLAN
MI01-01530OtherPHYSICIANS HEALTH PLAN
MI080D410020OtherCOMMUNITY BLUE PPO
MI4555579Medicaid
MI080D410020OtherBLUE CHOICE
MI0853310325OtherBLUE CROSS BLUE SHIELD
MI1009245OtherHEALTH ADVANTAGE
MI7133458OtherAETNA