Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 17970 | MN |
NPI | 1043423437 |
---|---|
Provider Name | Dr. Alexander A Levitan |
First Address | New Brighton, MN 55112-5166 |
Second Address | New Brighton, MN 55112-5166 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A95413 | (02) |