Provider Demographics
NPI:1043305576
Name:LEVIN, ROBERT M (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:113 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-3603
Mailing Address - Country:US
Mailing Address - Phone:617-489-6636
Mailing Address - Fax:617-489-6636
Practice Address - Street 1:113 BELMONT ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-3603
Practice Address - Country:US
Practice Address - Phone:617-489-6636
Practice Address - Fax:617-489-6636
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA436932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3014479Medicaid
MA164561000OtherMAGELLAN BEHAVIORAL HEALT
MA043693OtherTUFTS HEALTH PLAN
MAB11635OtherBLUE CROSS/BLUE SHIELD
MAB11635OtherBLUE CROSS/BLUE SHIELD
MA164561000OtherMAGELLAN BEHAVIORAL HEALT