Provider Demographics
NPI:1184200925
Name:LEVY, CHRISTOPHER EVERETT (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:EVERETT
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:CHRISTOPHER
Other - Middle Name:EVERETT
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CHRIS
Mailing Address - Street 1:1129 BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-5475
Mailing Address - Country:US
Mailing Address - Phone:818-917-8396
Mailing Address - Fax:
Practice Address - Street 1:9260 W SUNSET RD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4903
Practice Address - Country:US
Practice Address - Phone:702-916-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty