Provider Demographics
NPI:1316968142
Name:FIRST, LEWIS R (MD, MS, FAAP)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:R
Last Name:FIRST
Suffix:
Gender:M
Credentials:MD, MS, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GIVEN COURTYARD S 250
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05405-0001
Mailing Address - Country:US
Mailing Address - Phone:802-656-0027
Mailing Address - Fax:802-656-2077
Practice Address - Street 1:GIVEN COURTYARD S 250
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05405-0001
Practice Address - Country:US
Practice Address - Phone:802-656-0027
Practice Address - Fax:802-656-2077
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2013-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT(#042-0008978)208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics