Edward R Lewis
Individual provider Active NPI Contractor · Kansas City, MO
NPI 1609011972 · NPPES record last updated Dec 15, 2008
Key facts
- NPI
- 1609011972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 9630 N Bradford Ave
Kansas City, MO 64154-1722 - Phone
- (816) 405-2760
- Fax
- (816) 891-7481
- NPI assigned
- Dec 15, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Medical Resources, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
9630 N Bradford Ave
Kansas City, MO 64154-1722
Mailing address
9630 N Bradford Ave
Kansas City, MO 64154-1722
Phone (816) 405-2760
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.