Individual
DR. EDMUND JOSEPH LEBAUER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1126 N CHURCH ST, SUITE 300, GREENSBORO, NC 27401-1000
(336) 547-1700
Mailing address
PO BOX 890195, CHARLOTTE, NC 28289-0195
(336) 547-1700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11887
NC
207RC0000X
Cardiovascular Disease Physician
11887
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26888
MEDCOST
NC
01
—
4097819
AETNA
NC
01
—
51335
BCBS NC
NC
01
—
615
PARTNERS MEDICARE
NC
05
—
8951335
—
NC
Enumeration date
04/13/2006
Last updated
09/11/2025
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