Provider Demographics
NPI:1497733646
Name:LEVIN, CAROL B (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:B
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2147 COMMONS PKWY
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-6922
Mailing Address - Country:US
Mailing Address - Phone:517-381-0496
Mailing Address - Fax:517-377-1677
Practice Address - Street 1:2147 COMMONS PKWY
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-6922
Practice Address - Country:US
Practice Address - Phone:517-381-0496
Practice Address - Fax:517-377-1677
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010426082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0330183Medicare ID - Type Unspecified