Mr Bruce Donald Lewis Jr, PA-C is a medicare enrolled "Physician Assistant - Medical" in Edgewood, Maryland. His current practice location is
2719 Pulaski Hwy, Edgewood, Maryland. You can reach out to his office (for appointments etc.) via phone at
(410) 612-0374.
Mr Bruce Donald Lewis Jr is licensed to practice in Maryland (license number C0002016) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1205995578.
Provider's Profile
Full Name | Mr Bruce Donald Lewis Jr |
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Gender | Male |
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Speciality | Physician Assistant - Medical |
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Location | 2719 Pulaski Hwy, Edgewood, Maryland |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1205995578
- Provider Enumeration Date: 12/06/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 0941351415
- Enrollment ID: I20090624000682
Medical Identifiers
Medical identifiers for Mr Bruce Donald Lewis Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205995578 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | C0002016 (Maryland) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Bruce Donald Lewis Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Bruce Donald Lewis Jr, PA-C 1005 Starboard Ct, Edgewood, MD 21040-1340 Ph: (410) 612-2178 | Mr Bruce Donald Lewis Jr, PA-C 2719 Pulaski Hwy, Edgewood, MD 21040-1315 Ph: (410) 612-0374 |
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