Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 34720 | OK |
NPI | 1013275908 |
---|---|
Provider Name | Samuel Levin |
First Address | Edmond, OK 73013-5898 |
Second Address | Oklahoma City, OK 73104-5047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2012 |
Last Update Date | 10/02/2020 |