Provider Demographics
NPI:1306801998
Name:LEWANDOWSKI, LESA ORLANDO (PAC)
Entity type:Individual
Prefix:MRS
First Name:LESA
Middle Name:ORLANDO
Last Name:LEWANDOWSKI
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MS
Other - First Name:LESA
Other - Middle Name:MARIE
Other - Last Name:ORLANDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:170 MEDICAL PARK RD
Mailing Address - Street 2:103
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8540
Mailing Address - Country:US
Mailing Address - Phone:704-660-4094
Mailing Address - Fax:704-660-8901
Practice Address - Street 1:170 MEDICAL PARK RD
Practice Address - Street 2:SUITE103
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8540
Practice Address - Country:US
Practice Address - Phone:704-660-4094
Practice Address - Fax:704-660-8901
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103206207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
M00683828OtherDEA
P33180Medicare UPIN