Provider Demographics
NPI:1386601615
Name:LEWIS, STEVEN L (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:3701 CORRIERE RD STE 23
Practice Address - Street 2:
Practice Address - City:PALMER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18045-7991
Practice Address - Country:US
Practice Address - Phone:484-591-7120
Practice Address - Fax:484-591-7121
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4624262084V0102X, 2084N0400X
IL030699142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036069914Medicaid
ILCS336033848OtherIL DEPT OF FE PROF REG
ILCS336033848OtherIL DEPT OF FE PROF REG
D16329Medicare UPIN
AL3063877OtherDEA FED DRUG ENFORCEMENT