Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 42160 | CO |
NPI | 1093793838 |
---|---|
Provider Name | Dr. James W Levine |
First Address | Greeley, CO 80631-5112 |
Second Address | Greeley, CO 80631-5132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 31/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
42052734 | (05) | CO |
I02607 | (02) | CO |
P00944710 | MEDICARE RAILROAD CARRIER PTAN (01) | CO |