| Lewis Family Practice Pc | |
|
1088 W Baltimore Pike Suite #2208 Media PA 19063-5146 | |
| (610) 891-3049 | |
| (610) 891-3919 |
| Full Name | Lewis Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1088 W Baltimore Pike, Media, Pennsylvania |
| Authorized Official Name and Position | Michele Miller (MANAGER) |
| Authorized Official Contact | 6108913905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewis Family Practice Pc 1088 W Baltimore Pike Suite #2208 Media PA 19063-5146 Ph: (610) 891-3049 | Lewis Family Practice Pc 1088 W Baltimore Pike Suite #2208 Media PA 19063-5146 Ph: (610) 891-3049 |
| NPI Number | 1790795995 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2961661491 |
|---|---|
| Medicare Enrollment ID | O20120302000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790795995 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD059944L (Pennsylvania) | Primary |
| Provider Name | Walter E Lewis |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1396755625 PECOS PAC ID: 7012970510 Enrollment ID: I20041109000016 |
| Provider Name | Lisa Broody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487737417 PECOS PAC ID: 4284074311 Enrollment ID: I20240506003659 |
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