Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 40113 | CO |
NPI | 1316921158 |
---|---|
Provider Name | Dr. Monroe I Levine |
First Address | Thornton, CO 80229-4300 |
Second Address | Thornton, CO 80229-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
88879534 | (05) | CO |
D45943 | (02) | CO |