Provider Demographics
NPI:1164479507
Name:LEVIN, BRIAN M (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:M
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:STE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:410-871-1072
Mailing Address - Fax:443-738-7213
Practice Address - Street 1:410 MALCOLM DR
Practice Address - Street 2:SUITE A
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6160
Practice Address - Country:US
Practice Address - Phone:410-876-1633
Practice Address - Fax:410-840-2100
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2013-08-22
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Provider Licenses
StateLicense IDTaxonomies
MDD0063144208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407692300Medicaid
MD731LL252Medicare PIN
MDI06660Medicare UPIN