Basic Information
| Provider Information | |||||||||
| NPI: | 1932411949 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEVITT | ||||||||
| FirstName: | MARA | ||||||||
| MiddleName: | LAUREN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1028 LEE ANN DR NE STE 200 | ||||||||
| Address2: | EMERGENCY MEDICINE | ||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280252915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047821892 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1028 LEE ANN DR NE STE 200 | ||||||||
| Address2: | EMERGENCY MEDICINE | ||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280252915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047821892 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2010 | ||||||||
| LastUpdateDate: | 10/01/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | LL32644 | SC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.