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NPI Code Detail

MEDICARE: DR. MARK LEVINE MD

MEDICARE: DR. MARK LEVINE 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
1207R00000XInternal Medicine Physician42-0008661VT

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 : 1790793214
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK LEVINE MD
Provider Business Mailing Address
First Line : 209 DEER RUN DR
Second Line :
City : SHELBURNE
State : VT
Zip : 05482-7655
Country : US
Telephone Number : 802-985-3869
Fax Number :
Provider Business Practice Location Address
First Line : 87 MAIN ST
Second Line :
City : ESSEX JUNCTION
State : VT
Zip : 05452-3234
Country : US
Telephone Number : 802-847-8354
Fax Number : 802-847-6575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MARK LEVINE MD” Practice Location

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