Individual
DR. MICHAEL GEORGE LEVRINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DHSC PT ECS
Contact information
Practice address
11670 BENNINGTON WOODS RD, RESTON, VA 20194-1610
(703) 787-8434
(703) 787-8434
Mailing address
11670 BENNINGTON WOODS RD, RESTON, VA 20194-1610
(703) 787-8434
(703) 787-8434
Taxonomy
Speciality
Code
Description
License number
State
2251E1300X
Clinical Electrophysiology Physical Therapist
Primary
2305005514
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010027268
—
VA
01
—
259143
ANTHEM BC BS PROV NUMBER
VA
01
—
299977
MAMSI PROVIDER #
VA
01
—
7740445
AETNA PROVIDER NUMBER
VA
Enumeration date
01/17/2007
Last updated
07/01/2016
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