Provider Demographics
NPI:1609873926
Name:LEVINE, STEPHEN B (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:B
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5901A PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:STE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5382
Mailing Address - Country:US
Mailing Address - Phone:678-892-2020
Mailing Address - Fax:678-538-1950
Practice Address - Street 1:5995 BARFIELD RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4411
Practice Address - Country:US
Practice Address - Phone:404-256-9600
Practice Address - Fax:404-250-0440
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2013-11-15
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Provider Licenses
StateLicense IDTaxonomies
GA016093207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000084994DMedicaid
GA180034319OtherRR MEDICARE
GA2036252OtherAETNA HMO
GA00341OtherCOVENTRY PPO
GA7344OtherCOVENTRY HMO
GA0890562OtherUHC
GA4038255OtherAETNA
GAN337407OtherWELLCARE
GA582209517OtherWORK COMP
GA732560OtherBCBS
GA2036252OtherAETNA HMO
GA0890562OtherUHC
GAD45940Medicare UPIN