Lewis, Michael Ray

Lewis, Michael Ray is an sole proprietor health care provider with primary practice located at 4500 Old Pass Rd , Gulfport MS 39501-2585. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Lewis, Michael Ray can be contacted via phone (228) 865-7890.

Contact Information

Primary practice address
4500 Old Pass Rd Gulfport MS 39501-2585
Fax: (228) 868-7402
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 13326 Mississippi

Profile Details

NPI number 1568409878
LBN Legal business name Lewis, Michael Ray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 2nd, 2006
Last updated Oct 28th, 2009 - about 16 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 1568409878 NPPES
Mississippi Other 060065909 MEDICARE SECONDARY PAYOR
Mississippi MEDICAID 00116618 MEDICARE SECONDARY PAYOR

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