Provider Demographics
NPI:1326379488
Name:LEVENTHAL, MITCHELL WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:WARREN
Last Name:LEVENTHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6630 CUMMINGS CT
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-6729
Mailing Address - Country:US
Mailing Address - Phone:440-318-1333
Mailing Address - Fax:
Practice Address - Street 1:6630 CUMMINGS CT
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-6729
Practice Address - Country:US
Practice Address - Phone:440-318-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35036605207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine