Provider Demographics
NPI:1366584856
Name:LEWIS, DAVID MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:LEWIS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:14 NORCROSS ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-3810
Mailing Address - Country:US
Mailing Address - Phone:770-650-9797
Mailing Address - Fax:770-650-2668
Practice Address - Street 1:14 NORCROSS ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-3810
Practice Address - Country:US
Practice Address - Phone:770-650-9797
Practice Address - Fax:770-650-2668
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA0233802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry