Provider Demographics
NPI:1831183672
Name:LEWIS, STEVEN TEEFORD (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:TEEFORD
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 1:70 WESTWIND RD
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-3726
Mailing Address - Country:US
Mailing Address - Phone:540-721-7333
Mailing Address - Fax:540-721-4971
Practice Address - Street 1:70 WESTWIND RD
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-3726
Practice Address - Country:US
Practice Address - Phone:540-721-7333
Practice Address - Fax:540-721-4971
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005603307Medicaid
VA005603307Medicaid
VA00V914501Medicare PIN