Provider Demographics
NPI:1033177233
Name:LEVIN, ANDREW S (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:S
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10 HOSPITAL DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-6603
Mailing Address - Country:US
Mailing Address - Phone:413-534-3244
Mailing Address - Fax:413-535-3297
Practice Address - Street 1:10 HOSPITAL DR
Practice Address - Street 2:SUITE 307
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6603
Practice Address - Country:US
Practice Address - Phone:413-534-3244
Practice Address - Fax:413-535-3297
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA37025207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6185282Medicaid
MAB97650Medicare UPIN
MA6185282Medicaid