Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 011403 | GA |
NPI | 1093707002 |
---|---|
Provider Name | Louis I Levy |
First Address | Columbus, GA 31917-6685 |
Second Address | Columbus, GA 31901-1527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00039223F | (05) | GA |
D45945 | (02) |