Basic Information
Provider Information
NPI: 1003800251
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEVIN
FirstName: SHEILA
MiddleName: GAY
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12510 PROSPERITY DR
Address2: SUITE 200
City: SILVER SPRING
State: MD
PostalCode: 209041663
CountryCode: US
TelephoneNumber: 2404855200
FaxNumber: 3016256906
Practice Location
Address1: 14955 SHADY GROVE RD
Address2: SUITE 150
City: ROCKVILLE
State: MD
PostalCode: 208508700
CountryCode: US
TelephoneNumber: 3013403252
FaxNumber: 3013401423
Other Information
ProviderEnumerationDate: 09/02/2005
LastUpdateDate: 07/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100XD0030869MDY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

ID Information
IDTypeStateIssuerDescription
55638100005MD MEDICAID
10000265101MDRAILROAD MEDICAREOTHER


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