Provider Demographics
NPI:1073606216
Name:LEVIN, TERRY L (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:L
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3695 GREEN RD
Mailing Address - Street 2:UNIT 22778
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7939
Mailing Address - Country:US
Mailing Address - Phone:330-655-1869
Mailing Address - Fax:330-655-3828
Practice Address - Street 1:5655 HUDSON DR STE 210
Practice Address - Street 2:ARIS RADIOLOGY
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4455
Practice Address - Country:US
Practice Address - Phone:330-655-1869
Practice Address - Fax:330-655-3828
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-1240282085P0229X
NY1679952085R0202X
KS04-338392085R0202X
MO20090178082085R0202X
CAG1544132085R0202X, 2085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4383812OtherAETNA- KCR
KY000057058KOtherHUMANA- KCR
IN201025850Medicaid
KY50030566OtherPASSPORT- KCR
KY0000685190OtherANTHEM- KCR
KY7100115270Medicaid
KY0000685190OtherANTHEM- KCR