Provider Demographics
NPI:1043325517
Name:DONALD S. LEVINE, M.D. , P.C..
Entity Type:Organization
Organization Name:DONALD S. LEVINE, M.D. , P.C..
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-840-1388
Mailing Address - Street 1:50 MEMORIAL DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2238
Mailing Address - Country:US
Mailing Address - Phone:978-840-1388
Mailing Address - Fax:978-534-4925
Practice Address - Street 1:50 MEMORIAL DR
Practice Address - Street 2:SUITE 110
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-840-1388
Practice Address - Fax:978-534-4925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52691207RE0101X
FLME54648207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9707361Medicaid
MAJ03001Medicare ID - Type UnspecifiedMEDICARE
MA9707361Medicaid