NICHOLAS ANDREW LEWIS (NPI# 1164719993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164719993 |
| Entity Type | Individual |
| Full Name | NICHOLAS ANDREW LEWIS |
| Credential | M.D. |
| Practice Address |
4646 John R St Detroit MI 48201 |
| Mailing Address |
4646 John R St Detroit MI 48201-1916 |
| Practice Telephone | 3135764645 |
| Mailing Telephone | 3135764645 |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2018-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
4301101660 | MI | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A142218 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1500 San Pablo St, 2nd Floor, Los Angeles, CA 900335313 | 3234428541 | 3234428755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574571 | Nicholas Lewis | Case Manager/Care Coordinator | 2803 Akron Rd, Wooster, OH 44691-7904 | 2020-10-05 |
| 1841648854 | Nicholas Lewis | Community Health Worker | 3449 E Rezanof Dr, Kodiak, AK 99615-6952 | 2016-05-31 |
| 1316338965 | Nicholas Lewis | Pharmacist | 4560 Se International Way, Suite 101, Milwaukie, OR 97222-4628 | 2015-02-17 |
| 1134372386 | Nicholas J Lewis | Internal Medicine | 1818 S 10th Ave, Caldwell, ID 83605-4803 | 2008-11-01 |
| Street Address |
4646 JOHN R ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356344121 | Christopher Emil Hermann | Nurse Practitioner | 4646 John R St, Detroit, MI 48201-1916 | 2005-05-24 |
| 1881293892 | Derrick Williams | Registered Nurse | 4646 John R St, Detroit, MI 48201-1916 | 2020-10-21 |
| 1598371544 | Sonia Govil | Dietitian, Registered | 4646 John R St, Detroit, MI 48201-1916 | 2020-09-16 |
| 1740893569 | Nicholas Edward Peters | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-31 |
| 1710597455 | Amber Michelle Young | Social Worker | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-07 |
| 1104434471 | Zeinab H Moussa | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-22 |
| 1235747346 | Samantha Beth Lewis | Psychologist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-15 |
| 1477171189 | Rima Mohammad Fardos | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-09 |
| 1992323869 | Sarah F Waqhar | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-08 |
| 1619594181 | Mellisa Ann Boyle | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194017970 | Zhen Wu | Radiology | 4646 John R St., Radiology Department, Detroit, MI 48201 | 2011-05-11 |
| 1548492028 | Joseph Ugorji | Radiology | 5766 Trumbull St Apt 112, Detroit, MI 48208-1776 | 2009-08-17 |
| 1194954867 | Nithin Thummala | Radiology | 4201 Saint Antoine St Rm 3l-8, Detroit, MI 48201-2153 | 2009-07-02 |
| 1659509305 | Sanjay N Soni | Radiology | 4201 St Antoine 9c Uhc, Detroit Medical Center, Detroit, MI 48201 | 2009-07-01 |
| 1700010311 | Pratima Karia | Radiology | 4201 Saint Antoine St # 3l8, Department of Radiology, Detroit, MI 48201-2153 | 2009-05-11 |
| 1386816288 | Roland E Gazaille IIi | Radiology | 2799 West Grand Blvd A-4 Diagnostic Radiology, Henry Ford Health System, Detroit, MI 48202-3450 | 2008-03-31 |
| 1144430422 | Khalid Kurbanali Javeri | Radiology | 2799 W Grand Blvd Ste 109, Detroit, MI 48202-2608 | 2007-05-23 |
| 1588871826 | Khurshaid Alam | Radiology | 4648 John R St, John Dingell Va Medical Center, Detroit, MI 48201-1916 | 2007-05-17 |
| 1659449395 | Matthew C. Rheinboldt | Radiology | 2799 W. Grand Blvd, Henry Ford Dept of Radiology, Detroit, MI 48202-2689 | 2006-12-01 |
| 1528077567 | Sampath Ramachandran | Radiology | 2799 West Grand Boulevard, Detroit, MI 48202 | 2006-08-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.