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NPI Code Detail

MEDICARE: DR. JOSHUA D LEVINE M.D.

MEDICARE: DR. JOSHUA D LEVINE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology Physician200301255NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3135WAOTHERNCBCBSNC
430096770OTHERSCSELECT HEALTH OF SC

General Provider Information

NPI Number : 1275557126
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSHUA D LEVINE M.D.
Provider Business Mailing Address
First Line : 6035 FAIRVIEW RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3256
Country : US
Telephone Number : 704-295-3000
Fax Number : 704-295-3253
Provider Business Practice Location Address
First Line : 5933 BLAKENEY PARK DR
Second Line : SUITE 200
City : CHARLOTTE
State : NC
Zip : 28277-5713
Country : US
Telephone Number : 704-295-3311
Fax Number : 704-295-3322
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 03/31/2021

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