MEDICARE: DAVID J. LEVINE, M.D., P.A.

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
1	261QM2500X	Medical Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689995433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID J. LEVINE, M.D., P.A.

Provider Business Mailing Address
First Line	:	19271 MONTGOMERY VILLAGE AVE
Second Line	:	SUITE H-2
City	:	MONTGOMERY VILLAGE
State	:	MD
Zip	:	20886-5021
Country	:	US
Telephone Number	:	301-977-2300
Fax Number	:	301-977-2348

Provider Business Practice Location Address
First Line	:	19271 MONTGOMERY VILLAGE AVE
Second Line	:	SUITE H-2
City	:	MONTGOMERY VILLAGE
State	:	MD
Zip	:	20886-5021
Country	:	US
Telephone Number	:	301-977-2300
Fax Number	:	301-977-2348

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID JAY LEVINE
Credential	:	M.D.
Telephone Number	:	301-977-2300

Provider Enumeration Date	:	06/16/2010
Last Update Date	:	06/16/2010

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