Provider Demographics
NPI:1578793758
Name:LEVITIN, HOWARD WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:WILLIAM
Last Name:LEVITIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7112
Mailing Address - Street 2:DEPT. #31
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46207-7112
Mailing Address - Country:US
Mailing Address - Phone:317-528-8148
Mailing Address - Fax:317-528-8115
Practice Address - Street 1:8111 S EMERSON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8601
Practice Address - Country:US
Practice Address - Phone:317-528-8148
Practice Address - Fax:317-528-8115
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035251207PE0004X
IN01035251A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100325080Medicaid
IN100325080Medicaid