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General NPI Number Information
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NPI Number | 1336187582
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Entity Type | Individual
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Provider Name | GARY MARC LEVINE MD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 100 MEMORIAL HOSPITAL DR SUITE 1E
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City | MOBILE
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State | AL
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Zip | 36608
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Country | US
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Telephone | 251-316-3868
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Fax | 251-316-3583
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Provider Business Mailing Address
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Address Line | PO BOX 7627
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City | MOBILE
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State | AL
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Zip | 36670-0627
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Country | US
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Telephone | 251-316-3868
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Fax | 251-316-3583
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 27815
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License Number State | AL
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