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NPI Code Detail

MEDICARE: DR. MICHAEL HARRIS LEVINE SC.D.

MEDICARE: DR. MICHAEL HARRIS LEVINE SC.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
1103TS0200XSchool PsychologistAZ

General Provider Information

NPI Number : 1932113024
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL HARRIS LEVINE SC.D.
Provider Business Mailing Address
First Line : 235 W WESTERN AVE
Second Line :
City : AVONDALE
State : AZ
Zip : 85323-1848
Country : US
Telephone Number : 623-772-5027
Fax Number :
Provider Business Practice Location Address
First Line : 235 W WESTERN AVE
Second Line :
City : AVONDALE
State : AZ
Zip : 85323-1848
Country : US
Telephone Number : 623-772-5027
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/27/2007

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