Provider Demographics
NPI:1780494989
Name:LEWIS, MYRIAN
Entity type:Individual
Prefix:
First Name:MYRIAN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 STONEMONT DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-8229
Mailing Address - Country:US
Mailing Address - Phone:720-837-2996
Mailing Address - Fax:
Practice Address - Street 1:521 STONEMONT DR
Practice Address - Street 2:
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108-8229
Practice Address - Country:US
Practice Address - Phone:720-837-2996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter