Individual
FREDERIC EVAN LEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2520 ABERDEEN BLVD, GASTONIA, NC 28054-0635
(704) 868-8400
(704) 868-8493
Mailing address
2520 ABERDEEN BLVD, GASTONIA, NC 28054-0635
(704) 868-8400
(704) 868-8493
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
94-00559
NC
207Y00000X
Otolaryngology Physician
Primary
9400559
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040008664
RAILROAD MEDICARE
—
01
—
10-41162
UNITED HEALTHCARE
NC
01
—
11536
PARTNERS HEALTHPLAN
NC
01
—
168235
MIDSOUTH
NC
01
—
2031685
AETNA HEALTHPLAN
NC
01
—
2084887005
CIGNA HEALTHCARE
NC
01
—
2103800
MAMSI
NC
01
—
343002
COVENTRY HEALTHCARE
NC
01
—
5177X
BLUE CROSS BLUE SHIELD
NC
01
—
72586
MEDCOST
NC
05
—
895177X
—
NC
01
—
N00559
SOUTH CAROLINA MEDICAID
SC
Enumeration date
09/20/2005
Last updated
07/08/2022
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