Lewellen, Donald R

Lewellen, Donald R is an individual health care provider with primary practice located at 4801 Expo Dr , Manitowoc WI 54220-9341. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Lewellen, Donald R can be contacted via phone (920) 684-4429.

Contact Information

Primary practice address
4801 Expo Dr Manitowoc WI 54220-9341
Phone: (920) 684-4429
Fax: (920) 684-6892
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 27021 Wisconsin

Profile Details

NPI number 1558362046
LBN Legal business name Lewellen, Donald R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Feb 25th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558362046 NPPES
Wisconsin Other 037664001 ADMINASTAR FEDERAL
Wisconsin MEDICAID 30675000 ADMINASTAR FEDERAL

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