Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN008950 | GA |
NPI | 1114921012 |
---|---|
Provider Name | Dr. Steven Jule Levy |
First Address | Marietta, GA 30068-5518 |
Second Address | Marietta, GA 30068-5518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 10/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U21691 | (02) | GA |