Provider Demographics
NPI:1124315601
Name:LEWANDOWSKI, NATHAN DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:DAVID
Last Name:LEWANDOWSKI
Suffix:
Gender:M
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:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93902-0480
Mailing Address - Country:US
Mailing Address - Phone:831-649-1000
Mailing Address - Fax:
Practice Address - Street 1:23845 HOLMAN HWY
Practice Address - Street 2:227
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5900
Practice Address - Country:US
Practice Address - Phone:831-624-3579
Practice Address - Fax:831-624-3615
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35. 122788207Q00000X
CAA141213207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA207Q00000XOtherFAMILY MEDICINE