Provider Demographics
NPI:1063575322
Name:LEWIS, RANI (MD)
Entity type:Individual
Prefix:
First Name:RANI
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:
Other - Last Name:RANDOLPH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1407 UNION AVE
Mailing Address - Street 2:STE 802
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3627
Mailing Address - Country:US
Mailing Address - Phone:901-259-5341
Mailing Address - Fax:901-259-5344
Practice Address - Street 1:1407 UNION AVE
Practice Address - Street 2:STE 802
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3627
Practice Address - Country:US
Practice Address - Phone:901-259-5341
Practice Address - Fax:901-259-5344
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN024718207VM0101X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4857OtherNPI