Provider Demographics
NPI:1891846226
Name:LEVY, MICHA (MD)
Entity Type:Individual
Prefix:PROF
First Name:MICHA
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HASHAKED ST
Mailing Address - Street 2:
Mailing Address - City:CAESAREA
Mailing Address - State:CAESAREA
Mailing Address - Zip Code:38900
Mailing Address - Country:IL
Mailing Address - Phone:9724-636-3041
Mailing Address - Fax:9724-626-1304
Practice Address - Street 1:6 HASHAKED ST
Practice Address - Street 2:
Practice Address - City:CAESAREA
Practice Address - State:CAESAREA
Practice Address - Zip Code:38900
Practice Address - Country:IL
Practice Address - Phone:9724-636-3041
Practice Address - Fax:9724-626-1304
Is Sole Proprietor?:No
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA46406207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine