Provider Demographics
NPI:1801904172
Name:LEVI, CIGDEM (MD)
Entity type:Individual
Prefix:DR
First Name:CIGDEM
Middle Name:
Last Name:LEVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CIGDEM
Other - Middle Name:
Other - Last Name:OZBASLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:313 KERCHEVAL AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:313-343-5921
Mailing Address - Fax:313-343-5992
Practice Address - Street 1:21400 KELLY ROAD
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021
Practice Address - Country:US
Practice Address - Phone:313-343-5900
Practice Address - Fax:313-343-5992
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301079436207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H97061Medicare UPIN