Individual
DAMIAN IVAN LEBAMOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3737 SOUTHERN BLVD STE 2000, DAYTON, OH 45429-1285
(937) 228-4126
(937) 228-0247
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35070091
OH
2086S0129X
Vascular Surgery Physician
35070091
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0241974
—
OH
Enumeration date
02/17/2006
Last updated
05/06/2021
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