Individual
DMITRY LEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
344 THOMPSON RD, WEBSTER, MA 01570-1509
(508) 671-4050
(508) 949-6742
Mailing address
630 PLANTATION ST, WORCESTER, MA 01605-2038
(508) 368-5529
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
054922
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042472266
THREE RIVERS
MA
01
—
11SCCSX
MEDICARE
GA
01
—
1588685671
CIGNA HEALTH CARE
MA
01
—
47159
HNE
MA
05
—
544466114A
—
GA
01
—
AA157019
HPHC
MA
Enumeration date
07/22/2006
Last updated
11/23/2009
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