MEDICARE: DR. HUBERT LEVEQUE 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
1	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	D18379	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1370866-011	OTHER		CIGNA
2	416863-01	OTHER	MD	CAREFIRST BCBS
3	0763-0002	OTHER	DC	BCBS DC
4	458918	OTHER		AETNA
5	22131	OTHER	MD	UNITED HEALTH/MAMSI

General Provider Information

NPI Number	:	1437152584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUBERT LEVEQUE M.D.

Provider Business Mailing Address
First Line	:	18111 PRINCE PHILIP DR
Second Line	:	STE 224
City	:	OLNEY
State	:	MD
Zip	:	20832-1504
Country	:	US
Telephone Number	:	301-774-0074
Fax Number	:	301-774-0640

Provider Business Practice Location Address
First Line	:	18111 PRINCE PHILIP DR
Second Line	:	STE 224
City	:	OLNEY
State	:	MD
Zip	:	20832-1504
Country	:	US
Telephone Number	:	301-774-0074
Fax Number	:	301-774-0640

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/09/2007

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Directions to “ DR. HUBERT LEVEQUE M.D.” Practice Location

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