Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | 26531 | IA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 26531 | IA |
NPI | 1154329092 |
---|---|
Provider Name | Dr. James Michael Levett |
First Address | Cedar Rapids, IA 52406-3178 |
Second Address | Cedar Rapids, IA 52403-2404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 17/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0048652 | (05) | IA |
40864 | BLUE CROSS/BLUE SHIELD (01) | IA |
A03613 | (02) | IA |