Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 9801353 | NC |
Y | 208600000X | Surgeon | 9801353 | NC |
N | 2086S0102X | Surgical Critical Care | 9801353 | NC |
N | 2086X0206X | Surgical Oncologist | 9801353 | NC |
NPI | 1275518334 |
---|---|
Provider Name | Edward Allen Levine |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 12/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11366 | BCBS (01) | NC |
1800028000 | (05) | WV |
26889 | PARTNERS (01) | NC |
5879653 | AETNA (01) | |
7311052 | (05) | VA |
81807 | MEDCOST (01) | NC |
8911366 | (05) | NC |
E49096 | (02) | |
Q01354 | (05) | SC |