Provider Demographics
NPI:1962439000
Name:LEWIS, WILLIAM JOHN III (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOHN
Last Name:LEWIS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:SUITE 650 LANKENAU MEDICAL BUILDING EAST
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-896-6800
Mailing Address - Fax:610-896-5627
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE 650 LANKENAU MEDICAL BUILDING EAST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-896-6800
Practice Address - Fax:610-896-5627
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013989E207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAD71198Medicare UPIN
PA122038HPGMedicare ID - Type Unspecified