Individual
DEBORAH JO LEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11885 E 12 MILE RD, SUTIE #300A, WARREN, MI 48093-3474
(586) 582-6791
(586) 582-6792
Mailing address
11885 E 12 MILE RD, SUITE #300A, WARREN, MI 48093-3474
(586) 582-6791
(586) 582-6792
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101007248
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
417185711
—
MI
01
—
700H270060
BCBSM
MI
Enumeration date
07/15/2005
Last updated
09/25/2013
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