Provider Demographics
NPI:1871564104
Name:LEWIS, STEVEN EDWARD (CCC-A)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:EDWARD
Last Name:LEWIS
Suffix:
Gender:M
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NORFOLK NAVAL SHIPYARD BRANCH HEALTH CLINIC
Mailing Address - Street 2:BLDG 277
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23709-5000
Mailing Address - Country:US
Mailing Address - Phone:757-314-6912
Mailing Address - Fax:757-314-6946
Practice Address - Street 1:NORFOLK NAVAL SHIPYARD BRANCH HEALTH CLINIC
Practice Address - Street 2:BLDG 277
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23709-5000
Practice Address - Country:US
Practice Address - Phone:757-314-6912
Practice Address - Fax:757-314-6946
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001061231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist