Healthcare Provider Details

I. General information

NPI: 1679683452
Provider Name (Legal Business Name): JOSEPH LEVAY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 BOWLES AVE
FENTON MO
63026-2394
US

IV. Provider business mailing address

1015 BOWLES AVE
FENTON MO
63026-2394
US

V. Phone/Fax

Practice location:
  • Phone: 636-496-2000
  • Fax: 636-496-4901
Mailing address:
  • Phone: 636-496-2000
  • Fax: 636-496-4901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036151838
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2020009667
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A6189
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2020009667
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036151838
License Number StateIL
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number336166
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: