Provider Demographics
NPI:1144279423
Name:LEVIN, DAVID ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANDREW
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14995 SHADY GROVE RD STE 350
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-8726
Mailing Address - Country:US
Mailing Address - Phone:301-251-1433
Mailing Address - Fax:301-251-2768
Practice Address - Street 1:14995 SHADY GROVE RD STE 350
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-8726
Practice Address - Country:US
Practice Address - Phone:301-251-1433
Practice Address - Fax:301-251-2768
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-121355207X00000X, 207XS0117X
NY237073207XS0117X
MDD72577207XS0117X, 207X00000X
DCMD041850207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036121355Medicaid
IN200847410AMedicaid
ILI65476Medicare UPIN
ILR03655Medicare PIN
MD222797YUREMedicare PIN
IL036121355Medicaid