Healthcare Provider Details

I. General information

NPI: 1033275995
Provider Name (Legal Business Name): ERIC LEVENS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DR BLDG 10, CRC, RM 1E-3140
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

15001 SHADY GROVE RD SUITE 310
ROCKVILLE MD
20850-6352
US

V. Phone/Fax

Practice location:
  • Phone: 301-496-5800
  • Fax:
Mailing address:
  • Phone: 301-340-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberME 92010
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberD0062572
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberMD037096
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: