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)Name
Code
103TA0700X
103TC2200X
103TC0700X
103TE1100X
103TH0100X
103T00000X
103TR0400X
Primary Taxonomy
Yes
No
No
No
No
No
No
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