Individual
DR. LEE S LEVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2212 BROTHERS RD, SANTA FE, NM 87505-6903
(505) 992-4991
(505) 983-0568
Mailing address
2212 BROTHERS RD, SANTA FE, NM 87505-6903
(505) 992-4991
(505) 983-0568
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
NM90-70
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26476
—
NM
01
—
NM002957
BCBS
NM
01
—
PROVP14542
MOLINA SALUD
NM
Enumeration date
11/16/2006
Last updated
04/16/2008
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