Wallen Lewis, Maxine
Wallen Lewis, Maxine is an sole proprietor health care provider with primary practice located at 7831 Big Buck Dr , Baltimore MD 21244-2068. She recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Clinical Laboratory Director, Non-physician, which is considered as her primary health care specialty. Wallen Lewis, Maxine can be contacted via phone (443) 803-3937.Contact Information
Primary practice address
7831 Big Buck Dr
Baltimore MD 21244-2068
Phone: (443) 803-3937
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Technologists, Technicians & Other Technical Service Providers / Clinical Laboratory Director, Non-physician | 247ZC0005X | 21D2258698 | Maryland |
Profile Details
| NPI number | 1386374510 |
|---|---|
| LBN Legal business name | Wallen Lewis, Maxine |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 11th, 2022 |
| Last updated | Jun 11th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386374510 | NPPES |
| Maryland | MEDICAID | 21D22585698 |
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