Individual
KEITH D LEVENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(419) 526-8768
(419) 522-4697
Mailing address
308 GLESSNER AVE, MANSFIELD, OH 44903-2225
(419) 526-8768
(419) 522-4697
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35052841L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000233866
ANTHEM
OH
05
—
0610726
—
OH
Enumeration date
09/13/2006
Last updated
07/08/2007
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