Most Relevant Information
Provider Data
| NPI Number: | 1003392259 |
| Provider Name: | SHANELLE LEWIS |
| Entity Type: | Individual |
| Taxonomy Code: | 246QL0900X |
| Specialty: | Specialist/Technologist, Pathology |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/11/2018 |
| Last Updated: | 07/13/2018 |
Provider Practice Location
4484 COVINGTON HWY
DECATUR
GA
30035
Practice Location Phone/Fax
| Phone: | 3473132205 |
| Fax: |
Provider Mailing Location
5910 SHADOW ROCK DR
LITHONIA
GA
300583232
Provider Mailing Phone/Fax
| Phone: | 3473132205 |
| Fax: |