Provider Demographics
NPI:1659453017
Name:LEVIN, STEPHEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER UNIVERSITY RADIOLOGY
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2382
Practice Address - Fax:856-365-0472
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA243322085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ105533OtherPA BS HIGHMARK
NJ0079797000OtherAMERIHEALTH/KEYSTONE/IBC
NJ105533OtherAMERIHEALTH PPO/PA BS
NJ6045760OtherCIGNA
NJ01000584200OtherAMERICHOICE
NJ19149OtherUNIVERSITY HEALTH PLAN
NJ2183901Medicaid
NJ3396233OtherAETNA
NJP00129818OtherRR MEDICARE
NJ60002941OtherHORIZON NJ HEALTH
NJ105533OtherAMERIHEALTH PPO/PA BS
NJ3396233OtherAETNA