Provider Demographics
NPI:1871948109
Name:LEWIS, KAREN (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N 18TH AVE
Mailing Address - Street 2:#120
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85007-3232
Mailing Address - Country:US
Mailing Address - Phone:602-364-3856
Mailing Address - Fax:
Practice Address - Street 1:150 N 18TH AVE
Practice Address - Street 2:#120
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007-3232
Practice Address - Country:US
Practice Address - Phone:602-364-3856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-23
Last Update Date:2016-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ171372080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases