Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101036673 | VA |
NPI | 1013087295 |
---|---|
Provider Name | Paul A. Levine |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 31/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013087295 | (05) | VA |
A45628 | (02) |