1528172632 NPI number — MORRIS W. LEVINSOHN, M.D., INC.

Table of content: (NPI 1528172632)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528172632 NPI number — MORRIS W. LEVINSOHN, M.D., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MORRIS W. LEVINSOHN, M.D., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528172632
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/18/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4212 STATE ROUTE 306
Provider Second Line Business Mailing Address:
204
Provider Business Mailing Address City Name:
WILLOUGHBY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44094-9258
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-946-6725
Provider Business Mailing Address Fax Number:
440-946-3526

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4212 STATE ROUTE 306
Provider Second Line Business Practice Location Address:
204
Provider Business Practice Location Address City Name:
WILLOUGHBY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44094-9258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-946-6725
Provider Business Practice Location Address Fax Number:
440-946-3526
Provider Enumeration Date:
08/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LEVINSOHN
Authorized Official First Name:
MORRIS
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
440-946-6725

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  35034958L , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2731548 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".