Provider Demographics
NPI:1154324010
Name:LEVY, MARK NEAL (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:NEAL
Last Name:LEVY
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Gender:M
Credentials:DPM
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Mailing Address - Street 1:1201 SEVEN LOCKS RD
Mailing Address - Street 2:STE 202
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2956
Mailing Address - Country:US
Mailing Address - Phone:301-762-4636
Mailing Address - Fax:301-762-6228
Practice Address - Street 1:1201 SEVEN LOCKS RD
Practice Address - Street 2:STE 202
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854-2956
Practice Address - Country:US
Practice Address - Phone:301-762-4636
Practice Address - Fax:301-762-6228
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2013-01-11
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Provider Licenses
StateLicense IDTaxonomies
MD00534213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD79394-8500Medicaid
MD79394-8500Medicaid
MD413853Medicare PIN
MDT31181Medicare UPIN