Provider Demographics
NPI:1134123029
Name:LEVINE, DAVID JULIUS (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JULIUS
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E GUDE DR
Mailing Address - Street 2:STE 200
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1341
Mailing Address - Country:US
Mailing Address - Phone:301-933-7133
Mailing Address - Fax:301-933-7137
Practice Address - Street 1:1600 E GUDE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1341
Practice Address - Country:US
Practice Address - Phone:301-933-7133
Practice Address - Fax:301-933-7137
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01018213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD545098500Medicaid
MD545098500Medicaid
MD549PMedicare PIN