Individual
NICHOLAS LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
803 S MAIN ST STE 320, MOSCOW, ID 83843-2695
(208) 883-1008
(208) 883-4563
Mailing address
803 S MAIN ST STE 320, MOSCOW, ID 83843-2695
(208) 883-1008
(208) 883-4563
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
C143668
CA
207T00000X
Neurological Surgery Physician
Primary
M-17459
ID
Other
Enumeration date
05/25/2007
Last updated
12/12/2023
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