Individual
ETHAN C LEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5600 EUBANK BLVD NE STE 110, ALBUQUERQUE, NM 87111-1519
(314) 996-8810
Mailing address
7300 RANCH ROAD 2222, BLDG 1, STE 200, AUSTIN, TX 78730-3255
(512) 759-8932
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD2019-0595
NM
207ND0101X
MOHS-Micrographic Surgery Physician
A122015
CA
Other
Enumeration date
06/09/2011
Last updated
02/16/2023
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