Individual
EDWARD ALLEN LEVINE
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 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-6637
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9801353
NC
2086S0102X
Surgical Critical Care Physician
9801353
NC
2086X0206X
Surgical Oncology Physician
9801353
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11366
BCBS
NC
05
—
1800028000
—
WV
01
—
26889
PARTNERS
NC
01
—
5879653
AETNA
—
05
—
7311052
—
VA
01
—
81807
MEDCOST
NC
05
—
8911366
—
NC
05
—
Q01354
—
SC
Enumeration date
12/13/2005
Last updated
11/12/2010
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