Provider Demographics
NPI:1447288329
Name:LEWIN, FRED J (DC)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:J
Last Name:LEWIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6425 WADSWORTH BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-4438
Mailing Address - Country:US
Mailing Address - Phone:303-425-6796
Mailing Address - Fax:303-425-0810
Practice Address - Street 1:6425 WADSWORTH BLVD
Practice Address - Street 2:STE 100
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-4438
Practice Address - Country:US
Practice Address - Phone:303-425-6796
Practice Address - Fax:303-425-0810
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO4134111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U34115Medicare UPIN
CO800165Medicare PIN