Provider Demographics
NPI:1932128345
Name:LEVAN, JOSEPH R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:LEVAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2758 CENTURY BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3345
Mailing Address - Country:US
Mailing Address - Phone:610-375-0500
Mailing Address - Fax:610-373-0375
Practice Address - Street 1:2758 CENTURY BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3345
Practice Address - Country:US
Practice Address - Phone:610-375-0500
Practice Address - Fax:610-373-0375
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD058074L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0880104000OtherKEYSTONE HEALTH PLAN EAST
PA0015885760002Medicaid
PALE847082OtherHIGH BLUE SHIELD
PA01170602OtherKEYSTONE HEALTH PLAN CENT
PA5011168OtherAETNA
PA01170602OtherCAPITAL BLUE CROSS
PA01170602OtherKEYSTONE SR. BLUE
PA5011168OtherAETNA
PALE847082OtherHIGH BLUE SHIELD