Individual
DR. JONATHAN LEVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 COBB ST, CADILLAC, MI 49601-2588
(231) 775-6521
(231) 876-6519
Mailing address
520 COBB ST, CADILLAC, MI 49601-2588
(231) 775-6521
(231) 876-6519
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301053984
MI
207RC0000X
Cardiovascular Disease Physician
4301053984
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03940201
BCBS
MI
01
—
383361553050
COMMUNITY CHOICE
MI
05
—
427365010
—
MI
01
—
P53158
BCN
MI
Enumeration date
09/21/2005
Last updated
04/06/2017
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