Provider Demographics
NPI:1982473294
Name:LEWIS, ROBERT RONALD
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:RONALD
Last Name:LEWIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WEBER ST
Mailing Address - Street 2:
Mailing Address - City:RICHWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26261-1119
Mailing Address - Country:US
Mailing Address - Phone:304-619-8131
Mailing Address - Fax:
Practice Address - Street 1:5 WEBER ST
Practice Address - Street 2:
Practice Address - City:RICHWOOD
Practice Address - State:WV
Practice Address - Zip Code:26261-1119
Practice Address - Country:US
Practice Address - Phone:304-619-8131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant