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NPI Code Detail

MEDICARE: DR. JONATHAN LEVI M.D.

MEDICARE: DR. JONATHAN LEVI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician4301053984MI
2207R00000XInternal Medicine Physician4301053984MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1383361553050OTHERMICOMMUNITY CHOICE
203940201OTHERMIBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4P53158OTHERMIBCN

General Provider Information

NPI Number : 1538155023
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN LEVI M.D.
Provider Business Mailing Address
First Line : 520 COBB ST
Second Line :
City : CADILLAC
State : MI
Zip : 49601-2588
Country : US
Telephone Number : 231-775-6521
Fax Number : 231-876-6519
Provider Business Practice Location Address
First Line : 520 COBB ST
Second Line :
City : CADILLAC
State : MI
Zip : 49601-2588
Country : US
Telephone Number : 231-775-6521
Fax Number : 231-876-6519
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 04/06/2017

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Directions to “ DR. JONATHAN LEVI M.D.” Practice Location

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