Individual
SAMUEL C LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
516 DELAWARE ST SE, PWB 8TH FLOOR, CLINIC 8A, MINNEAPOLIS, MN 55455-0356
(612) 626-5900
Mailing address
420 DELAWARE STREET SE, UNIVERSITY OF MINNESOTA PHYSICIAN, MINNEAPOLIS, MN 55455
(612) 626-5900
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
30278
MN
207YX0901X
Otology & Neurotology Physician
30278
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051221
—
MT
01
—
065524
FAIRVIEW
MN
01
—
10-00019
MEDICA PRIMARY
MN
01
—
10-22589
MEDICA CHOICE
MN
01
—
100884
UCARE
MN
01
—
1009211
PREFERRED ONE
MN
05
—
274082600
—
MN
01
—
2T080LE
BLUE CROSS BLUE SHIELD
MN
05
—
30778200
—
WI
01
—
607398
ARAZ
MN
01
—
HP22089
HEALTH PARTNERS
MN
Enumeration date
10/10/2006
Last updated
10/26/2012
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