Individual
BOHDAN A LEBEDOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1050 W 10TH ST, ROLLA, MO 65401-2905
(573) 364-9000
(573) 202-2484
Mailing address
1050 W 10TH ST, ATTN: EXECUTIVE DIRECTOR OF PHYSICIAN CLINICS, ROLLA, MO 65401-2905
(573) 364-9000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01049329A
IN
207R00000X
Internal Medicine Physician
2010005856
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000183115
BLUE CROSS
IN
05
—
200191400
—
IN
Enumeration date
03/15/2006
Last updated
09/09/2025
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