| Organization Name: | MARC S LEWIS DPM SC |
| NPI Number: | 1396810362 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARC S LEWIS (OWNER) |
| Mailing Address: | 4614 S Packard Ave Cudahy |
| State: | WI US |
| Postal Code: | 531101417 |
| Phone Number: | 4144818584 |
| Fax Number: | 4144822211 |
| NPI Enumeration Date: | 11/22/2006 |
| NPI Last Update Date: | 08/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 774025 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |