Provider Demographics
NPI:1275976474
Name:LEWIS, ROBERT BENTON III (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BENTON
Last Name:LEWIS
Suffix:III
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 BATH RD STE 102
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2656
Mailing Address - Country:US
Mailing Address - Phone:207-442-0350
Mailing Address - Fax:207-618-5668
Practice Address - Street 1:430 BATH RD STE 102
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2656
Practice Address - Country:US
Practice Address - Phone:207-442-0350
Practice Address - Fax:207-618-5668
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD22036207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program