Provider Demographics
NPI:1508009796
Name:LEVIN, CAREY ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:CAREY
Middle Name:ELIZABETH
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:PO BOX 643
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-0643
Mailing Address - Country:US
Mailing Address - Phone:415-302-3731
Mailing Address - Fax:970-984-0293
Practice Address - Street 1:820 CASTLE VALLEY BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:NEW CASTLE
Practice Address - State:CO
Practice Address - Zip Code:81647-9480
Practice Address - Country:US
Practice Address - Phone:970-984-3333
Practice Address - Fax:970-984-0293
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49610208000000X
CAA107287208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62059262Medicaid
CO62059262Medicaid