Individual
MARK ROGER LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 S GREEN RD, SUITE 306A, SOUTH EUCLID, OH 44121-4128
(219) 291-9770
(216) 297-0550
Mailing address
1611 S GREEN RD, SUITE 306A, SOUTH EUCLID, OH 44121-4128
(219) 291-9770
(216) 297-0550
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35-02-9064-L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0181315
—
OH
Enumeration date
05/01/2006
Last updated
07/08/2007
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