Male or Other

Dr. Ethan R. Levine PH.D.

Adult Development & Aging Psychologist in Concord, NC(View on Map)

Full Name

Dr. Ethan R Levine PH.D.

NPI Number

1538300025

NPI Type

Individual Provider

Gender

Male

Enumeration Date

03/13/2009

Specialties

(Taxonomies)

Licenses

State

North Carolina

License Number

650

Contact
Information

Purpose

Mailing
Location

Address

101 CABARRUS AVE E
101 CABARRUS AVE E

City

Concord
Concord

State

NC
NC

Postal Code

28025-3699
28025-3699

Country

US
US

Telephone Number

(888) 849-7379
(888) 849-7379

Identifiers

Identifier

14040
6001139
P01164443

Identifier State

NC
NC
NC

Identifier Issuer

BCBS
Unknown
RR MEDICARE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 04/08/2020

Provider Address