1861609711 NPI number — ERIC M LEVIN MD

Table of content: (NPI 1861609711)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861609711 NPI number — ERIC M LEVIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ERIC M LEVIN MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861609711
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
144 S 8TH ST STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-2752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-267-2903
Provider Business Mailing Address Fax Number:
717-267-1130

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
144 S 8TH ST STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-2752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-267-2903
Provider Business Practice Location Address Fax Number:
717-267-1130
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LEVIN
Authorized Official First Name:
ANITA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
717-267-2903

Provider Taxonomy Codes

  • Taxonomy code: 2084N0600X , with the licence number:  PAMD039158L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1968316 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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