NPI 1518264142

Candice Y Lewis

Practitioner Health Maintenance Organization Madison, WI

Practice location

Address: 675 W.Washington Ave. Group Health Cooperative of South, Madison, WI 53703
Phone: (608) 257-9700
Mailing address: 1906 E Mifflin St # 2, Madison, WI 53704-4729

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 1141-146 (WI)

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Registry record

NPI: 1518264142
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Feb 2011
Record last updated: 17 Feb 2011

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.