Individual
ADAM C LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-4923
(401) 519-1604
(401) 272-0538
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
230670
MA
207P00000X
Emergency Medicine Physician
Primary
MD12929
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001113101
MEDICARE
RI
01
—
08/13/2009
NHPRI
RI
01
—
08012009
BCBSRI
RI
01
—
09/22/2009
TUFTS
RI
05
—
110084263A
—
MA
01
—
AL77320
MEDICAID
RI
Enumeration date
12/08/2006
Last updated
02/04/2010
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