Healthcare Provider Details

I. General information

NPI: 1467986950
Provider Name (Legal Business Name): DEBORAH LEVY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 BELLEVUE AVE STE 200
SAINT LOUIS MO
63117-1856
US

IV. Provider business mailing address

10663 COUNTRY VIEW DR
SAINT LOUIS MO
63141-7819
US

V. Phone/Fax

Practice location:
  • Phone: 314-977-7455
  • Fax: 314-977-7477
Mailing address:
  • Phone: 314-753-0744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number2024016554
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2024016554
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: