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General NPI Number Information
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NPI Number | 1912569047
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Entity Type | Individual
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Provider Name | ANNA LEVINE DO
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Gender | Female
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 11050 PARKVIEW CIRCLE DR
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City | FORT WAYNE
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State | IN
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Zip | 46845-1739
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Country | US
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Telephone | 833-724-8326
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Fax | 260-425-6845
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Provider Business Mailing Address
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Address Line | 11109 PARKVIEW PLAZA DR # 117
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City | FORT WAYNE
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State | IN
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Zip | 46845-1701
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Country | US
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Telephone |
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 02008404A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5151014035
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License Number State | MI
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