Individual
DR. PHILLIP D LEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-3000
Mailing address
21603 BEAUFORD LN, NORTHVILLE, MI 48167-9085
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301079601
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301079601
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104418810
—
MI
05
—
104418829
—
MI
05
—
104538747
—
MI
05
—
104538774
—
MI
01
—
PL079601
BC/BS OF MI
MI
Enumeration date
03/28/2006
Last updated
06/17/2010
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