Lewis, Kevan G

Lewis, Kevan G is an individual health care provider with primary practice located at 3059 Voyager Dr , Green Bay WI 54311-8303. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Lewis, Kevan G can be contacted via phone (920) 965-0345.

Contact Information

Primary practice address
3059 Voyager Dr Green Bay WI 54311-8303
Phone: (920) 965-0345
Fax: (920) 257-4559
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 53110-20 Wisconsin
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 51745 Minnesota
Allopathic & Osteopathic Physicians / Dermatology 207N00000X LP00514 Rhode Island
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 53110-020 Wisconsin

Profile Details

NPI number 1497970560
LBN Legal business name Lewis, Kevan G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2007
Last updated Mar 7th, 2023 - about last year

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 1497970560 NPPES
Iowa MEDICAID ENROLLED
Iowa Other P00787809
Iowa MEDICAID 1497970560
Iowa Other 53110-020
Iowa MEDICAID ENROLLED

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