Provider Demographics
NPI:1679654156
Name:LEVIN, ROBERT MEAD (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MEAD
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-302-8200
Mailing Address - Fax:
Practice Address - Street 1:1020 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-2504
Practice Address - Country:US
Practice Address - Phone:612-302-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN40305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP27115OtherHEALTH PARTNERS
MN812574OtherARAZ
MN01-09760OtherMEDICA-CHOICE
MN01-09760OtherMEDICA-PRIMARY
MN557326200Medicaid
MN36Q96LEOtherBCBS
MN122086OtherUCARE
MN1017630OtherPREFERREDONE
MN572859OtherFAIRVIEW
MN1017630OtherPREFERREDONE
MN36Q96LEOtherBCBS