Provider Demographics
NPI:1386274546
Name:LEWIS, ASHLEY MAUREEN (RDLDN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MAUREEN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RDLDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5539 WILLYS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2832
Mailing Address - Country:US
Mailing Address - Phone:410-530-5411
Mailing Address - Fax:
Practice Address - Street 1:10215 FERNWOOD RD STE 630
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1184
Practice Address - Country:US
Practice Address - Phone:240-449-3094
Practice Address - Fax:240-489-4415
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX4848133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered