Provider Demographics
NPI:1811962079
Name:LEW, MICHAEL ARNOLD (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ARNOLD
Last Name:LEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1650
Mailing Address - Country:US
Mailing Address - Phone:617-965-1717
Mailing Address - Fax:617-965-1994
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 301
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-965-1717
Practice Address - Fax:617-965-1994
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2010-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA33199207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2006014Medicaid
MA033199OtherTUFTS HEALTH PLAN
MAC16102OtherBCBS MA
MA033199OtherTUFTS HEALTH PLAN
MA2006014Medicaid