Provider Demographics
NPI:1730274218
Name:LEWIS, EVELYN CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:CHRISTOPHER
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 M L KING JR DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-3711
Mailing Address - Country:US
Mailing Address - Phone:404-696-7300
Mailing Address - Fax:404-699-3514
Practice Address - Street 1:3620 M L KING JR DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-3711
Practice Address - Country:US
Practice Address - Phone:404-696-7300
Practice Address - Fax:404-699-3514
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64133207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA944068206AMedicaid
GA9353141OtherCIGNA
GA2983453OtherUNITED HEALTH CARE
GA944068206CMedicaid
GA944068206DMedicaid
GA944068206EMedicaid
GA944068206FMedicaid
GA944068206BMedicaid
GA944068206GMedicaid
GA2983453OtherUNITED HEALTH CARE
GA944068206AMedicaid