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Individual

DR. MARK LEVINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
87 MAIN ST, ESSEX JUNCTION, VT 05452-3234
(802) 847-8354
(802) 847-6575
Mailing address
209 DEER RUN DR, SHELBURNE, VT 05482-7655
(802) 985-3869

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42-0008661
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005419
VT
Enumeration date
08/03/2006
Last updated
07/08/2007
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