Provider Demographics
NPI:1710906128
Name:LEWIS, MARK J (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:34525 N SCOTTSDALE RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-1287
Mailing Address - Country:US
Mailing Address - Phone:480-882-7550
Mailing Address - Fax:480-575-3076
Practice Address - Street 1:34525 N SCOTTSDALE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-1287
Practice Address - Country:US
Practice Address - Phone:480-882-7550
Practice Address - Fax:480-575-3076
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2025-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ32022207R00000X
WI69030207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ7551697OtherAETNA
AZ2Z6843OtherHEALTHNET
AZAZ0760272OtherBCBS
AZ7551697OtherAETNA
AZ2Z6843OtherHEALTHNET