Individual
EDWARD A LEBRIJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
285 W 12TH ST STE 112, PERU, IN 46970-1654
(765) 475-2388
(260) 479-2928
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(765) 475-2388
(260) 479-2917
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
639
MN
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07001260A
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
304
OK
213ES0103X
Foot & Ankle Surgery Podiatrist
PO60507271
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200445530A
—
OK
05
—
300005361
—
IN
Enumeration date
08/13/2006
Last updated
08/29/2023
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