Provider Demographics
NPI:1952405953
Name:LEVIN, ROGER J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:J
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:875 POPLAR CHURCH RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2203
Mailing Address - Country:US
Mailing Address - Phone:717-763-7400
Mailing Address - Fax:717-909-9567
Practice Address - Street 1:875 POPLAR CHURCH RD
Practice Address - Street 2:SUITE 320
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2203
Practice Address - Country:US
Practice Address - Phone:717-763-7400
Practice Address - Fax:717-909-9567
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD052509L174400000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1952405953OtherNPI
PA1952405953OtherNPI
PAF85573Medicare UPIN
PA143420ND3Medicare PIN