Individual
DMITRY LEVENSON
Active
Individual
DMITRY LEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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