Individual
PAVEL J LEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-6637
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
97 01209
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1066X
BCBS
NC
05
—
2004937000
—
WV
01
—
21432
PARTNERS
NC
01
—
5359565
AETNA
—
01
—
74316
MEDCOST
NC
05
—
7600909
—
VA
05
—
891066X
—
NC
05
—
Q01200
—
SC
Enumeration date
12/13/2005
Last updated
07/21/2017
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