Provider Demographics
NPI:1447253703
Name:LEWIS, JOHN W (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:71 MAIN ST
Mailing Address - City:NEWCASTLE
Mailing Address - State:ME
Mailing Address - Zip Code:04553-0216
Mailing Address - Country:US
Mailing Address - Phone:207-563-3782
Mailing Address - Fax:207-563-6977
Practice Address - Street 1:71 MAIN ST
Practice Address - Street 2:BOX 216
Practice Address - City:NEWCASTLE
Practice Address - State:ME
Practice Address - Zip Code:04553
Practice Address - Country:US
Practice Address - Phone:207-563-3782
Practice Address - Fax:207-563-6977
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2010-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD4200207W00000X
ME014945207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136895308Medicaid
ME329260099Medicaid
TX136895308Medicaid
ME329260099Medicaid
TXU73955Medicare UPIN
MEMM7798Medicare ID - Type Unspecified