Individual
ELIZABETH LE WANNEBO
Active
Individual
ELIZABETH LE WANNEBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD434557
PA
208M00000X
Hospitalist Physician
MD434557
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018317200
—
MD
05
—
102170568
—
PA
01
—
120275
GEISINGER HEALTH PLAN
PA
01
—
2056156
HIGHMARK BLUE SHIELD
PA
01
—
211210
JOHNS HOPKINS
PA
01
—
935776
CAREFIRST MD BCBS
MD
01
—
9928179
AETNA
PA
Enumeration date
06/10/2008
Last updated
12/23/2013
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