Provider Demographics
NPI:1437561842
Name:LEVY, VIVIAN (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8555 16TH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2850
Mailing Address - Country:US
Mailing Address - Phone:301-587-0518
Mailing Address - Fax:
Practice Address - Street 1:8555 16TH ST STE 220
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2850
Practice Address - Country:US
Practice Address - Phone:301-587-0518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293243207Q00000X
MDH0090975207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine