Individual
DOLLY R. QUISPE LEVEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7910 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4159
(260) 484-8830
(260) 843-1911
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(239) 236-2775
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
201075
LA
207RH0003X
Hematology & Oncology Physician
Primary
01072629A
IN
207RH0003X
Hematology & Oncology Physician
201075
LA
207RX0202X
Medical Oncology Physician
01072629A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0088372
—
OH
05
—
201184930
—
IN
Enumeration date
05/25/2007
Last updated
05/15/2025
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