Provider Demographics
NPI:1366473548
Name:LEVIN, HOWARD H (OD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:H
Last Name:LEVIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8109 HARFORD ROAD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234
Mailing Address - Country:US
Mailing Address - Phone:410-665-1779
Mailing Address - Fax:410-668-0614
Practice Address - Street 1:4313 EBENEZER ROAD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:410-529-1950
Practice Address - Fax:410-529-9073
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0640152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
693L384DMedicare ID - Type Unspecified
U09140Medicare UPIN