Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 24333 | MN |
NPI | 1003818824 |
---|---|
Provider Name | Richard M. Levinson |
First Address | Minneapolis, MN 55404-3711 |
Second Address | Minneapolis, MN 55404-3711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 21/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0098003 | PREFERREDONE (01) | MN |
09846LE | BLUE SHIELD (01) | MN |
1000010 | MEDICA PRIMARY (01) | MN |
1003802 | MEDICA CHOICE (01) | MN |
100645 | UCARE (01) | MN |
30284300 | MEDICAID - WISCONSIN (01) | WI |
402792200 | (05) | MN |
88313 | AMERICA'S PPO (01) | MN |
A94218 | (02) | MN |