Provider Demographics
NPI:1609494798
Name:LEVAN, HEATHER L (DVM)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:LEVAN
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 GRAVEL PIKE
Mailing Address - Street 2:
Mailing Address - City:PALM
Mailing Address - State:PA
Mailing Address - Zip Code:18070-1204
Mailing Address - Country:US
Mailing Address - Phone:215-679-7019
Mailing Address - Fax:
Practice Address - Street 1:919 GRAVEL PIKE
Practice Address - Street 2:
Practice Address - City:PALM
Practice Address - State:PA
Practice Address - Zip Code:18070-1204
Practice Address - Country:US
Practice Address - Phone:215-679-7019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABV014541208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice