1821181454 NPI number — DR. LAWRENCE CAMPBELL LEVY M.D.

Table of content: DR. LAWRENCE CAMPBELL LEVY M.D. (NPI 1821181454)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821181454 NPI number — DR. LAWRENCE CAMPBELL LEVY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEVY
Provider First Name:
LAWRENCE
Provider Middle Name:
CAMPBELL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEVY
Provider Other First Name:
L.
Provider Other Middle Name:
CAMPBELL
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1821181454
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/22/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 MEDICAL CENTER DR
Provider Second Line Business Mailing Address:
DHMC DEPARTMENT OF GASTROENTEROLOGY AND HEPATOLOGY
Provider Business Mailing Address City Name:
LEBANON
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03756-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
DHMC DEPARTMENT OF GASTROENTEROLOGY AND HEPATOLOGY
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03756-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-650-5145
Provider Business Practice Location Address Fax Number:
603-650-5225
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  12346 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1015442 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30208053 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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