Lewis, Matthew Thomas

Lewis, Matthew Thomas is an individual health care provider with primary practice located at 1705 Christy Dr Ste. 101, Jefferson City MO 65101-5195. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Lewis, Matthew Thomas can be contacted via phone (573) 635-0115.

Contact Information

Primary practice address
1705 Christy Dr Ste. 101 Jefferson City MO 65101-5195
Phone: (573) 635-0115
Fax: (573) 635-0116
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X R3P66 Missouri

Profile Details

NPI number 1205987831
LBN Legal business name Lewis, Matthew Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2007
Last updated Dec 18th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205987831 NPPES
Missouri MEDICAID 206665812

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