Provider Demographics
NPI:1477530145
Name:LEVIN, PAULA RAE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:RAE
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5657 S HIMALAYA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5307
Mailing Address - Country:US
Mailing Address - Phone:303-699-6200
Mailing Address - Fax:720-870-0242
Practice Address - Street 1:5657 S HIMALAYA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5307
Practice Address - Country:US
Practice Address - Phone:303-699-6200
Practice Address - Fax:720-870-0242
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29394208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01293943Medicaid
P5658Medicare ID - Type Unspecified
CO01293943Medicaid