MEDICARE: DR. ANTHONY P LEVATINO MD

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	207V00000X	Obstetrics & Gynecology Physician	2002-0273	NM

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	:	1578505087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY P LEVATINO MD

Provider Business Mailing Address
First Line	:	1135 S MAIN ST
Second Line	:	SUITE A
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-2946
Country	:	US
Telephone Number	:	575-522-9082
Fax Number	:	575-521-9169

Provider Business Practice Location Address
First Line	:	1135 S MAIN ST
Second Line	:	SUITE A
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-2946
Country	:	US
Telephone Number	:	575-522-9082
Fax Number	:	575-521-9169

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

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	11/23/2015

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