Provider Demographics
NPI:1669538674
Name:LEVY, DONALD B (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:B
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 1:850 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2477
Mailing Address - Country:US
Mailing Address - Phone:617-732-9700
Mailing Address - Fax:
Practice Address - Street 1:850 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2477
Practice Address - Country:US
Practice Address - Phone:671-732-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA49692207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0402542OtherUNITED HEALTH CARE
MAB10018903OtherCIGNA
MA708094OtherTUFTS HEALTH PLAN
MAJ04395OtherBCBS OF MA
MA65749OtherHARVARD PILGRIM
MAJ04395Medicare ID - Type UnspecifiedMEDICARE
MA65749OtherHARVARD PILGRIM