Provider Demographics
NPI:1669472841
Name:LEVIN, BARRY JAY (MD)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:JAY
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10215 FERNWOOD RD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1106
Mailing Address - Country:US
Mailing Address - Phone:301-897-5620
Mailing Address - Fax:301-897-3679
Practice Address - Street 1:10215 FERNWOOD RD
Practice Address - Street 2:SUITE 405
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1106
Practice Address - Country:US
Practice Address - Phone:301-897-5620
Practice Address - Fax:301-897-3679
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0020562208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01941B01Medicare ID - Type UnspecifiedINDIVIDUAL
MDC61596Medicare UPIN