Provider Demographics
NPI:1912317983
Name:LEVIN, ADAM B (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:B
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1211 FISH HATCHERY RD.
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1909
Mailing Address - Country:US
Mailing Address - Phone:608-252-8000
Mailing Address - Fax:608-410-2905
Practice Address - Street 1:1211 FISH HATCHERY RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1909
Practice Address - Country:US
Practice Address - Phone:608-252-8000
Practice Address - Fax:608-410-2905
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI65031207R00000X
WI49672207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1912317983Medicaid