NPI 1295093086

Demetrius Vinde Lewis

Practitioner Nursing Home Administrator Columbus, GA

Practice location

Address: 1314 Pagoda Dr, Columbus, GA 31907-4439
Phone: (706) 593-8727

Registered specialties (2)

Nursing Home Administrator Primary

Nursing Service Related Providers Taxonomy 376G00000X Licence NIIA005224 (GA)

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Licensed Practical Nurse

Nursing Service Providers Taxonomy 164W00000X Licence LPN052272 (GA)

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Registry record

NPI: 1295093086
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Apr 2012
Record last updated: 30 Apr 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.