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NPI Code Detail

MEDICARE: MATTHEW D LEVY

MEDICARE:   MATTHEW D LEVY
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
1208000000XPediatrics Physician74493WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366442196
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW D LEVY
Provider Business Mailing Address
First Line : 9000 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-4874
Country : US
Telephone Number : 414-607-5280
Fax Number :
Provider Business Practice Location Address
First Line : 9000 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-4874
Country : US
Telephone Number : 414-607-5280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 02/17/2021

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Directions to “ MATTHEW D LEVY ” Practice Location

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