Provider Demographics
NPI:1821018391
Name:LEVENTIS, ANNE-MARIE CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE-MARIE
Middle Name:CATHERINE
Last Name:LEVENTIS
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 1:202 BUCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-1358
Mailing Address - Country:US
Mailing Address - Phone:864-855-0274
Mailing Address - Fax:
Practice Address - Street 1:202 BUCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-1358
Practice Address - Country:US
Practice Address - Phone:864-855-0274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14235207Q00000X
NC200101463207Q00000X
AK5137207Q00000X
MI4301093180207Q00000X
METD101073207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO37171836Medicaid
CO37171836Medicaid
8HF111Medicare ID - Type Unspecified