Individual
DR. BRUCE ALAN LEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
410 E ROOSEVELT BLVD, PHILADELPHIA, PA 19120-4011
(215) 260-8654
(215) 969-6549
Mailing address
105 RENNARD TERRACE, PHILADELPHIA, PA 19116-2605
(215) 260-8654
(215) 969-6549
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC001718L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0501865
—
PA
01
—
31774
KEYSTONE MERCY HLTH PLAN
PA
Enumeration date
08/24/2006
Last updated
07/08/2007
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