Basic Information
| Provider Information | |||||||||
| NPI: | 1699018390 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEWIS | ||||||||
| FirstName: | MARSHA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 100186 | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326103003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522655911 | ||||||||
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| Practice Location | |||||||||
| Address1: | 455 S. WASHINGTON ST., SUITE 22 | ||||||||
| Address2: | WELLSPAN HEALTH, GETTYSBURG HOSPITAL EMERGENCY MEDICINE | ||||||||
| City: | GETTYSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173252534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173342121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2013 | ||||||||
| LastUpdateDate: | 08/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD457736 | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | ME126848 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.