Healthcare Provider Details

I. General information

NPI: 1508009796
Provider Name (Legal Business Name): CAREY ELIZABETH LEVIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 02/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 CASTLE VALLEY BLVD SUITE 204
NEW CASTLE CO
81647-9480
US

IV. Provider business mailing address

PO BOX 643
CARBONDALE CO
81623-0643
US

V. Phone/Fax

Practice location:
  • Phone: 970-984-3333
  • Fax: 970-984-0293
Mailing address:
  • Phone: 415-302-3731
  • Fax: 970-984-0293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number49610
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA107287
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: