Provider Demographics
NPI:1619136165
Name:LEVINE, YEHOSHUA C (MD)
Entity Type:Individual
Prefix:
First Name:YEHOSHUA
Middle Name:C
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:DEPT # 960
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0960
Mailing Address - Country:US
Mailing Address - Phone:901-763-0200
Mailing Address - Fax:901-761-4002
Practice Address - Street 1:1211 UNION AVE
Practice Address - Street 2:SUITE 475
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-6638
Practice Address - Country:US
Practice Address - Phone:901-274-2643
Practice Address - Fax:901-726-4237
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN53232207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ016530Medicaid
TN103I210873Medicare PIN