Provider Demographics
NPI:1255365268
Name:LEWIS MARSHALL MD & ASSOCIATES, PLLC
Entity type:Organization
Organization Name:LEWIS MARSHALL MD & ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-529-7932
Mailing Address - Street 1:1160 VARNUM ST NE
Mailing Address - Street 2:SUITE 317
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2107
Mailing Address - Country:US
Mailing Address - Phone:202-529-1961
Mailing Address - Fax:202-529-1964
Practice Address - Street 1:1160 VARNUM ST NE
Practice Address - Street 2:SUITE 317
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2107
Practice Address - Country:US
Practice Address - Phone:202-529-1961
Practice Address - Fax:202-529-1964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCA737OtherCAREFIRST BCBS
DC006998OtherTRAILBLAZER MEDICARE
DC006998OtherTRAILBLAZER MEDICARE