Individual
TERRY B LEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8004 MYRTLE TRACE DR, CONWAY, SC 29526-8945
(843) 347-7216
(843) 347-7218
Mailing address
PO BOX 2180, CONWAY, SC 29528-2180
(843) 347-7216
(843) 234-6990
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
09347
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093473
—
SC
01
—
621213
FIRST CHOICE IDENTIFIER
SC
05
—
PC6427
—
SC
Enumeration date
04/11/2006
Last updated
10/04/2016
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