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Mr. Bruce Donald Lewis JR., PA-C
Medical Physician Assistant in Edgewood, Maryland
NPI 1205995578

Bruce Donald Lewis JR. is a Medical Physician Assistant based in Edgewood, MD and is specialized in Medical. Bruce Donald Lewis JR. practices in Edgewood, MD and has the professional credentials of PA-C. The NPI Number for Bruce Donald Lewis JR. is 1205995578 and holds a License No. C0002016 (Maryland).

The current practice location address for Bruce Donald Lewis JR. is 2719 Pulaski Hwy, Edgewood, MD and can be reached out via phone at 410-612-0374.

Location: 2719 Pulaski Hwy, Edgewood, MD, 21040-1340
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205995578
Provider Name
Bruce Donald Lewis JR.
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
2719 Pulaski Hwy, Edgewood, MD, 21040-1340
Phone Number
410-612-0374
Fax Number
Provider Enumeration Date
12/06/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
2719 Pulaski Hwy
City
Edgewood
State
Maryland
Zip
21040-1315
Phone Number
410-612-0374
Fax Number
person
Provider Business Mailing Address Details
Address
2719 Pulaski Hwy
City
Edgewood
State
Maryland
Zip
21040-1315
Phone Number
410-612-0374
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
C0002016 (Maryland)
Definition
Definition to come...
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