Individual
DONALD LEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
21 E MAPLE ST, SUITE A, HAILEY, ID 83333-4900
(208) 788-3200
(208) 788-3386
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-14
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002498800
—
ID
01
—
P00434702
RR MEDICARE
ID
01
—
P01032140
MCRR
ID
Enumeration date
05/02/2006
Last updated
11/26/2013
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