Provider Demographics
NPI:1053303446
Name:LEVIN, STUART IRWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:IRWIN
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1040 CAMBRIDGE SQ
Mailing Address - Street 2:SUITE E
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-1800
Mailing Address - Country:US
Mailing Address - Phone:770-569-2020
Mailing Address - Fax:770-569-5550
Practice Address - Street 1:1040 CAMBRIDGE SQ
Practice Address - Street 2:SUITE E
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1800
Practice Address - Country:US
Practice Address - Phone:770-569-2020
Practice Address - Fax:770-569-5550
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2010-02-23
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Provider Licenses
StateLicense IDTaxonomies
GA025998207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD40445Medicare UPIN
GA08BBTDWMedicare ID - Type Unspecified