Individual
STACEY COLLEEN LEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1225 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6312
(219) 879-6531
(219) 872-7869
Mailing address
1225 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6312
(219) 879-6531
(219) 872-7869
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02002919
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200811020
—
IN
Enumeration date
07/13/2005
Last updated
05/22/2013
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