Individual
JUSTIN J LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 LAIDLEY ST, CHARLESTON, WV 25301-1614
(304) 343-4625
(304) 343-4626
Mailing address
PO BOX 840, LIMA, OH 45802-0840
(877) 574-7116
(419) 223-2726
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
237757
NY
2085R0202X
Diagnostic Radiology Physician
30090
WV
2085R0202X
Diagnostic Radiology Physician
MD19449
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440726
—
OH
05
—
1639369150
—
WV
Enumeration date
07/31/2007
Last updated
05/23/2024
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