MEDICARE: DR. ROBERT M LEVINE PHE

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	101YP2500X	Professional Counselor	4592612	TN

General Provider Information

NPI Number	:	1427086396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT M LEVINE PHE

Provider Business Mailing Address
First Line	:	334 MILL AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38107-1420
Country	:	US
Telephone Number	:	901-496-8811
Fax Number	:	870-630-6271

Provider Business Practice Location Address
First Line	:	334 MILL AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38107-1420
Country	:	US
Telephone Number	:	901-496-8811
Fax Number	:	870-630-6271

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	07/08/2007

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