Individual
DR. PETER E. LEVANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
560 W MITCHELL ST, SUITE 400, PETOSKEY, MI 49770-2275
(231) 487-2490
(231) 487-6055
Mailing address
560 W MITCHELL ST, SUITE 400, PETOSKEY, MI 49770-2275
(231) 487-2490
(231) 487-6055
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
4301048303
MI
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
4301048303
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0602429802
BLUE SHIELD INDIVIDUAL PI
MI
05
—
4087216
—
MI
01
—
P57812
BLUE CARE NETWORK
MI
Enumeration date
07/22/2006
Last updated
04/21/2014
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