Leebaw, Wayne Frederick

Leebaw, Wayne Frederick is an individual health care provider with primary practice located at 7701 York Ave S Suite 180, Edina MN 55435-5845. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Leebaw, Wayne Frederick can be contacted via phone (952) 927-7810.

Contact Information

Primary practice address
7701 York Ave S Suite 180 Edina MN 55435-5845
Phone: (952) 927-7810
Fax: (952) 927-6309
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 23267 Minnesota

Profile Details

NPI number 1033178405
LBN Legal business name Leebaw, Wayne Frederick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2006
Last updated May 6th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033178405 NPPES
Minnesota Other 120263C626 UCARE
Minnesota Other 21002 UCARE
Minnesota Other 3317283 UCARE
Minnesota Other 410999025 UCARE
Minnesota MEDICAID 656388100 UCARE
Minnesota Other 0256006 UCARE
Minnesota Other 3300003 UCARE
Minnesota Other HP13803 UCARE
Minnesota Other 53967LE UCARE
Minnesota Other 960540799004 UCARE
Minnesota Other 104082 UCARE

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