Lewis, Giavonni Mystique

Lewis, Giavonni Mystique is an individual health care provider with primary practice located at 50 N Medical Dr , Salt Lake City UT 84132-0100. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgical Critical Care is her primary health care specialty. Lewis, Giavonni Mystique can be contacted via phone (801) 581-8990.

Contact Information

Primary practice address
50 N Medical Dr Salt Lake City UT 84132-0100
Phone: (801) 581-8990
Fax: (801) 585-6005
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 8365805-1205 Utah
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 8365805-1205 Utah

Profile Details

NPI number 1528222775
LBN Legal business name Lewis, Giavonni Mystique
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2008
Last updated Nov 18th, 2021 - about 4 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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