Lewis, Elena Jean

Lewis, Elena Jean is an individual health care provider with primary practice located at 1324 W Milham Ave Suite 1, Portage MI 49024-2239. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Allergy. Allopathic & Osteopathic Physicians / Allergy is her primary health care specialty. Lewis, Elena Jean can be contacted via phone (269) 342-0196.

Contact Information

Primary practice address
1324 W Milham Ave Suite 1 Portage MI 49024-2239
Phone: (269) 342-0196
Fax: (269) 342-0532
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301085524 Michigan
Allopathic & Osteopathic Physicians / Allergy 207KA0200X EL085524 Michigan

Profile Details

NPI number 1194928994
LBN Legal business name Lewis, Elena Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2007
Last updated Dec 15th, 2016 - about 10 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 1194928994 NPPES
Michigan Other 700C910950 BCBSM
Michigan MEDICAID 1194928994 BCBSM

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