Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 01086326A | IN |
Y | 208600000X | Surgeon | 01086326A | IN |
N | 208200000X | Surgeon | 60821 | TN |
N | 208600000X | Surgeon | 60821 | TN |
NPI | 1013350040 |
---|---|
Provider Name | Dr. Jeremy Holzmacher Levin |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-1239 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 14/02/2022 |