Provider Demographics
NPI:1780791129
Name:LEVY, STEVEN MARC (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARC
Last Name:LEVY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22861 ASHTON WOODS DR
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-6965
Mailing Address - Country:US
Mailing Address - Phone:703-327-3556
Mailing Address - Fax:
Practice Address - Street 1:1360 BEVERLY RD STE 102
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3621
Practice Address - Country:US
Practice Address - Phone:703-893-6388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001425111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA803825CO6Medicare ID - Type Unspecified