Provider Demographics
NPI:1629058813
Name:LEVI, TANIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:TANIA
Middle Name:A
Last Name:LEVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 N HIGHWAY 190
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5158
Mailing Address - Country:US
Mailing Address - Phone:985-809-6195
Mailing Address - Fax:985-809-6199
Practice Address - Street 1:1980 N HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5158
Practice Address - Country:US
Practice Address - Phone:985-809-6195
Practice Address - Fax:985-809-6199
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL018251207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4339953OtherAETNA
LA720478620LEVOtherOCHSNER
LA1378054Medicaid
LA26883430002OtherCIGNA
LAL018251OtherSTATE LICENSE NUMBER
LA1378054Medicaid
LA54707CV70Medicare PIN