Individual
DR. LEONARD LEO LEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26517 W WASHINGTON ST, PETERSBURG, VA 23803
(804) 524-7658
Mailing address
PO BOX 4030, PETERSBURG, VA 23803-0030
(804) 524-7658
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101039118
VA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
0101039118
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101039118
STATE LICENSE
VA
Enumeration date
02/02/2006
Last updated
11/23/2009
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