Provider Demographics
NPI:1265445753
Name:LEVIN, MATTHEW W (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:W
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:259 OLD STATE ROUTE 30
Mailing Address - Street 2:SUITE C
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6992
Mailing Address - Country:US
Mailing Address - Phone:724-216-9300
Mailing Address - Fax:724-216-9302
Practice Address - Street 1:259 OLD STATE ROUTE 30
Practice Address - Street 2:SUITE C
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6992
Practice Address - Country:US
Practice Address - Phone:724-216-9300
Practice Address - Fax:724-216-9302
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD036704E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0440238000OtherINDEPENDEMCE BLUE SHIELD
PA0012052450001Medicaid
PAP00442997OtherRAILROAD MEDICARE
PA612112OtherHIGHMARK BLUE SHIELD
PAE73125Medicare UPIN
PA612112OtherHIGHMARK BLUE SHIELD