Provider Demographics
NPI:1962228536
Name:LEWIS MEHL MADRONA MD PHD & ASSOCIATES
Entity type:Organization
Organization Name:LEWIS MEHL MADRONA MD PHD & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHL-MADRONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-772-1099
Mailing Address - Street 1:288 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-3433
Mailing Address - Country:US
Mailing Address - Phone:808-772-1099
Mailing Address - Fax:207-406-5354
Practice Address - Street 1:288 MAIN ST
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473-3433
Practice Address - Country:US
Practice Address - Phone:808-772-1099
Practice Address - Fax:207-406-5354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-28
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty