Provider Demographics
NPI:1154363695
Name:GUZMAN, LEVIS M (MD)
Entity type:Individual
Prefix:DR
First Name:LEVIS
Middle Name:M
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 ALLENS AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-5010
Mailing Address - Country:US
Mailing Address - Phone:401-444-0400
Mailing Address - Fax:
Practice Address - Street 1:1 WARREN WAY
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-5000
Practice Address - Country:US
Practice Address - Phone:401-444-0530
Practice Address - Fax:401-444-0423
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224785207R00000X
RIMD11701207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI3939259OtherAETNA
RI31309-0OtherBC&BS
RI477624OtherTUFTS
RI9004057OtherEDS
RIAA85327OtherHARVARD PILGRIM
RI0412686OtherUNITEDHEALTH CARE
RI1376761544Medicaid
RI412804OtherBLUE CHIP
RI31091OtherNEIGHBORHOOD