MEDICARE: DR. SHELDON C LEVIN PH 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
1	103G00000X	Clinical Neuropsychologist	02138	MD
2	103G00000X	Clinical Neuropsychologist	976	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1366504136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELDON C LEVIN PH D

Provider Business Mailing Address
First Line	:	3229 PIGNATELLI CRESCENT
Second Line	:
City	:	MT. PLEASANT
State	:	SC
Zip	:	29466
Country	:	US
Telephone Number	:	843-216-2535
Fax Number	:	843-216-2528

Provider Business Practice Location Address
First Line	:	913 BOWMAN RD.
Second Line	:	BUILDING #2
City	:	MT. PLEASANT
State	:	SC
Zip	:	29464-3235
Country	:	US
Telephone Number	:	843-216-2535
Fax Number	:	843-216-2528

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	05/16/2016

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