Provider Demographics
NPI:1437140456
Name:LEVIN, EMILY B (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:B
Last Name:LEVIN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:29355 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1018
Mailing Address - Country:US
Mailing Address - Phone:248-353-0880
Mailing Address - Fax:248-353-3646
Practice Address - Street 1:29355 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1053
Practice Address - Country:US
Practice Address - Phone:248-353-0880
Practice Address - Fax:248-353-3646
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2014-09-07
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Provider Licenses
StateLicense IDTaxonomies
MI4301076028207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I06351Medicare UPIN
MI0M07900Medicare PIN