Provider Demographics
NPI:1871777995
Name:BARRY J. LEVIN, M.D. LLC
Entity type:Organization
Organization Name:BARRY J. LEVIN, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-897-5620
Mailing Address - Street 1:10215 FERNWOOD RD STE 405
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1191
Mailing Address - Country:US
Mailing Address - Phone:301-897-5620
Mailing Address - Fax:301-897-3679
Practice Address - Street 1:10215 FERNWOOD RD STE 405
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1191
Practice Address - Country:US
Practice Address - Phone:301-897-5620
Practice Address - Fax:301-897-3679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01941Medicare UPIN