Individual
MARK J LE VINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2630 EUCLID AVE, #736, EUCLID, OH 44132
(216) 261-3376
(216) 261-3926
Mailing address
2630 EUCLID AVE, #736, EUCLID, OH 44132
(216) 261-3376
(216) 261-3926
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35043529
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0403227
—
OH
Enumeration date
12/04/2006
Last updated
07/08/2007
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