Provider Demographics
NPI:1568457166
Name:LEVIN, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:131 BOSTON POST RD
Mailing Address - Street 2:P.O. BOX 490
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1605
Mailing Address - Country:US
Mailing Address - Phone:860-691-1044
Mailing Address - Fax:860-691-1050
Practice Address - Street 1:131 BOSTON POST RD
Practice Address - Street 2:SUITE 5
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1605
Practice Address - Country:US
Practice Address - Phone:860-691-1044
Practice Address - Fax:860-691-1050
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2010-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT023047207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001230473Medicaid
CT010023047CT01OtherANTHEM BS
490000111Medicare PIN
CTD33503Medicare UPIN