Provider Demographics
NPI:1841510666
Name:LEVENSON, TRESSA ILENE (MD)
Entity type:Individual
Prefix:
First Name:TRESSA
Middle Name:ILENE
Last Name:LEVENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5780 PEACHTREE DUNWOODY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1513
Mailing Address - Country:US
Mailing Address - Phone:404-303-1224
Mailing Address - Fax:404-303-1325
Practice Address - Street 1:ATLANTA WOMEN'S SPECIALISTS (AWS)
Practice Address - Street 2:5445 MERIDIAN MARK ROAD NE
Practice Address - City:SUITE 430
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-252-5196
Practice Address - Fax:404-252-2414
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA071828207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003146520AMedicaid
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