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Individual

LEO L MEDUNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1760 COUNTY ROAD J, SAUNDERS MEDICAL CENTER, WAHOO, NE 68066-4152
(402) 443-4191
(402) 443-1440
Mailing address
1760 COUNTY ROAD J, SAUNDERS MEDICAL CENTER, WAHOO, NE 68066-4152
(402) 443-4191
(402) 443-1440

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
18618
NE
207Q00000X
Family Medicine Physician
Primary
NE18618
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080188771
RAILROAD MEDICARE
01
099262
MEDICARE GROUP
05
76070872013
NE
Enumeration date
04/14/2006
Last updated
01/27/2011
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