=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255661708
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEWART J LEVINE M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2010
-----------------------------------------------------
Last Update Date | 01/06/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9000 ROCKVILLE PIKE NIH, BUILDING 10, ROOM 6D03, MSC 1590
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20892-1590
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-402-1448
-----------------------------------------------------
Fax | 301-435-2883
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9000 ROCKVILLE PIKE NIH, BUILDING 10, ROOM 6D03, MSC 1590
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20892-1590
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-402-1448
-----------------------------------------------------
Fax | 301-435-2883
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | D0038280
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | MD037015
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------