DR. GLEN LEW (NPI# 1295799161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295799161 |
| Entity Type | Individual |
| Full Name | DR. GLEN LEW |
| Credential | MD |
| Practice Address |
5455 Meridian Mark Rd Suite 400 Atlanta GA 30342-1654 |
| Practice Telephone | 4047853240 |
| Practice Fax Number | 4047853510 |
| Mailing Telephone | 4047853240 |
| Mailing Fax Number | 4047853510 |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2013-12-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
041457 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000826614 | 05 |
| Street Address |
5455 MERIDIAN MARK RD SUITE 400 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30342-1654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295279917 | Lisa Sitz | Nurse Practitioner | 5455 Meridian Mark Rd, Atlanta, GA 30342 | 2016-12-14 |
| 1952757189 | Lindsey Jacobs | Nurse Practitioner | 5455 Meridian Mark Rd, Suite 400, Atlanta, GA 30342-1654 | 2016-05-06 |
| 1982943452 | Kimberly Nicole Steinberg | Nurse Practitioner | 5455 Meridian Mark Rd, Suite 130, Atlanta, GA 30342 | 2013-02-04 |
| 1184886947 | Joanna Grossman Newton | Pediatrics | 5455 Meridian Mark Rd, Suite 400, Atlanta, GA 30342 | 2008-07-01 |
| 1205011954 | Kristine Borden Whigham | Clinical Neuropsychologist | 5455 Meridian Mark Rd, Suite 180, Atlanta, GA 30342 | 2007-12-31 |
| 1275655326 | Barunashish Brahma | Neurological Surgery | 5455 Meridian Mark Rd, Ste 540, Atlanta, GA 30342 | 2007-04-06 |
| 1255475091 | Pediatric Neurosurgery Assoc At Children's Healthcare of Atlanta LLC | Neurological Surgery | 5455 Meridian Mark Rd, Suite 540, Atlanta, GA 30342 | 2007-02-16 |
| 1386714103 | J C Shirley Jr. | Dentist | 5455 Meridian Mark Rd, Suite 200, Atlanta, GA 30342 | 2006-11-09 |
| 1225063308 | Robert N Vincent | Pediatrics | 5455 Meridian Mark Rd, Ste 530, Atlanta, GA 30342 | 2006-07-11 |
| 1043247257 | Jack E Thomas Jr. | Dentist | 5455 Meridian Mark Rd, Ste 210, Atlanta, GA 30342 | 2006-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
| 1255945184 | Jennifer Lynne Cole | Behavior Technician | 5555 Glenridge Con Suite 200, Atlanta, GA 30342 | 2020-09-08 |
| 1093336232 | Van Tran | Respiratory Therapist, Registered | 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 | 2020-04-28 |
| 1356978340 | Twyla Douglas Jackson I | Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 | 2020-03-27 | |
| 1760013411 | Emily Hamm | Dietitian, Registered | 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 | 2020-01-31 |
| 1043855984 | Mackenzie Tucker Wayda | Registered Nurse | 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 | 2019-11-14 |
| 1386288454 | Tiauna Lashun Cochman | Psychologist | 1307 Glenridge Dr, Sandy Springs, GA 30342 | 2019-11-01 |
| 1164074399 | Stephen J. White | Hearing Instrument Specialist | 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 | 2019-07-09 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1760954705 | Mishele Walker LLC | Counselor | 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 | 2018-12-31 |
| Find all providers in zip 30342 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518386853 | Rafi Kazi | Pediatrics | 5461 Meridian Mark Rd, Atlanta, GA 30342-3007 | 2014-04-15 |
| 1871936823 | Michael Hugh White | Pediatrics | 5461 Meridian Mark Road Ne, Suite 400, Atlanta, GA 30342 | 2013-04-09 |
| 1568624351 | Gary M Woods | Pediatrics | 5455 Meridian Marks Rd Ste 400, Atlanta, GA 30342 | 2008-07-02 |
| 1295993087 | Karen Elizabeth Effinger | Pediatrics | 2015 Uppergate Dr Fl 4, Atlanta, GA 30322-2200 | 2008-05-28 |
| 1114007549 | Robert Craig Castellino | Pediatrics | 14015 Clifton Rd, Atlanta, GA 30322-0001 | 2006-10-17 |
| 1417916768 | Carolyn M Bennett | Pediatrics | 1450 Clifton Rd Ne, 4th Floor, Atlanta, GA 30322-1053 | 2006-03-23 |
| 1275504169 | Tamara N New | Pediatrics | Aflac Cancer Center and Blood Disorders Service, Scottish Rite, 5455 Meridian Mark Rd, Suite 400, Atlanta, GA 30342 | 2006-01-30 |
| 1235664343 | Sharmila Raghunandan | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2017-04-26 |
| 1376961730 | Anthony Ross | Pediatrics | 100 Woodruff Cir Ne Ste 327, Atlanta, GA 30322-1334 | 2014-04-02 |
| 1528486362 | Megan Christine Brown | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-2570 | 2014-03-30 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.