Provider Demographics
NPI:1770527186
Name:LEWIS, RICHARD BARRON (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BARRON
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 1:40 LEWIS BAY RD
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5210
Mailing Address - Country:US
Mailing Address - Phone:508-775-0800
Mailing Address - Fax:508-771-8565
Practice Address - Street 1:40 LEWIS BAY RD
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5210
Practice Address - Country:US
Practice Address - Phone:508-775-0800
Practice Address - Fax:508-771-8565
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA34641208600000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0131199Medicaid
MA248124200OtherOFFICE OF WORKERS COMP
MA3078425OtherAETNA
MA0000029634OtherBMC
MA034641OtherTUFTS
MA8234OtherHPHC
MAL15115OtherBC/BS
MA020013140OtherRAILROAD MEDICARE
MAB20231801OtherCIGNA
MA020013140OtherRAILROAD MEDICARE
MA034641OtherTUFTS