Provider Demographics
NPI:1528267887
Name:LEVINE, ADAM MAXWELL (DO)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:MAXWELL
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:210 W ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1715
Mailing Address - Country:US
Mailing Address - Phone:856-546-3003
Mailing Address - Fax:
Practice Address - Street 1:210 W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1770
Practice Address - Country:US
Practice Address - Phone:856-546-3003
Practice Address - Fax:856-547-5337
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08691500207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0409898Medicaid
NJ349990Medicare PIN