Individual
DR. LEE A LEVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3733 BROADWAY, GARY, IN 46409-1501
(219) 887-0030
Mailing address
3733 BROADWAY, GARY, IN 46409-1501
(219) 887-0030
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001648B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100167250
—
IN
Enumeration date
04/27/2006
Last updated
08/19/2011
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