Healthcare Provider Details

I. General information

NPI: 1437251162
Provider Name (Legal Business Name): HOWARD I LEVY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 EXECUTIVE PARK SOUTH NE SUITE 3021
ATLANTA GA
30329-2208
US

IV. Provider business mailing address

59 EXECUTIVE PARK SOUTH NE SUITE 3021
ATLANTA GA
30329-2208
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-7000
  • Fax: 404-778-7117
Mailing address:
  • Phone: 404-778-7000
  • Fax: 404-778-7117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number36207
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: