Individual
MARC A LAVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD070920L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017988220001
—
PA
01
—
0800550000
KEYSTONE IBC
PA
01
—
127376
HIGHMARK BLUE SHIELD
PA
01
—
232691968
HEALTH PARTNERS
PA
01
—
30106257
KEYSTONE MERCY
PA
01
—
8317363
AETNA
PA
01
—
P01043213
RAILROAD MEDICARE
PA
Enumeration date
05/31/2005
Last updated
11/05/2012
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