Provider Demographics
NPI:1336146562
Name:LEVIN, WILLIAM D (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:19 FRIENDSHIP ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2200
Mailing Address - Country:US
Mailing Address - Phone:401-845-2113
Mailing Address - Fax:401-845-1529
Practice Address - Street 1:19 FRIENDSHIP ST
Practice Address - Street 2:SUITE 130
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2200
Practice Address - Country:US
Practice Address - Phone:401-845-2113
Practice Address - Fax:401-845-1529
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIMD 05361207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI20378-0OtherRI BC/BS
RI7003355Medicaid
RI003646OtherRI BLUE CHIP
RI7003355Medicaid