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Individual

DR. JACOB DANIEL LEVY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1011 BOWLES AVE, SUITE 300, RICHMOND HEIGHTS, MO 63117
(636) 496-5048
Mailing address
2665 N DECATUR RD, SUITE 260, DECATUR, GA 30033-6149
(404) 297-9077
(404) 296-1220

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101263074
VA
207RC0000X
Cardiovascular Disease Physician
01079565A
IN
207RC0000X
Cardiovascular Disease Physician
036145353
IL
207RC0000X
Cardiovascular Disease Physician
04-41155
KS
207RC0000X
Cardiovascular Disease Physician
Primary
057393
GA
207RC0000X
Cardiovascular Disease Physician
2264571
NY
207RC0000X
Cardiovascular Disease Physician
32799
OK
207RC0000X
Cardiovascular Disease Physician
68773
WI
207RC0000X
Cardiovascular Disease Physician
D84453
MD
207RC0000X
Cardiovascular Disease Physician
ME133455
FL
207RC0000X
Cardiovascular Disease Physician
R6432
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0-570-912-6
ECFMG
01
057393
GA STATE LICENSE
GA
01
2264571
NY STATE LICENSE
NY
Enumeration date
07/22/2006
Last updated
03/13/2023
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