Individual
DR. MARK EDWARD LEVENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1591 MEDICAL DR, POTTSTOWN, PA 19464-3224
(610) 326-8005
(610) 327-9629
Mailing address
1591 MEDICAL DR, POTTSTOWN, PA 19464-3224
(610) 326-8005
(610) 327-9629
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
OS10111
FL
207NS0135X
Procedural Dermatology Physician
Primary
OS013669
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851401
BLUE SHIELD
PA
01
—
AB191
GROUP NUMBER
FL
Enumeration date
05/18/2006
Last updated
12/21/2010
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