Basic Information
Provider Information
NPI: 1194886531
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEWIS
FirstName: PAUL
MiddleName: E
NamePrefix: DR.
NameSuffix: II
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 E JEFFERSON ST
Address2: KAISER PERMANENTE MEDICARE ENROLLMENT
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018162424
FaxNumber:  
Practice Location
Address1: 10810 CONNECTICUT AVE
Address2: KAISER PERMANENTE KENSINGTON MEDICAL CENTER
City: KENSINGTON
State: MD
PostalCode: 208952138
CountryCode: US
TelephoneNumber: 3019297100
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/12/2006
LastUpdateDate: 12/06/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XD35007MDY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000X0101029324VAN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000XMD16556DCN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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