Individual
DR. JAY BERRY LEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3125 SPRINGBANK LN, SUITE E, CHARLOTTE, NC 28226-3378
(704) 381-3510
(704) 540-3668
Mailing address
PO BOX 602148, CHARLOTTE, NC 28260-2148
(704) 381-3510
(704) 540-3668
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
9600282
NC
2088P0231X
Pediatric Urology Physician
18483
SC
2088P0231X
Pediatric Urology Physician
Primary
9600282
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003895954
—
NC
01
—
5953113
AETNA
SC
01
—
63276
MEDCOST
SC
05
—
8951818
—
NC
05
—
N00282
—
SC
Enumeration date
01/10/2006
Last updated
10/13/2014
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