Individual
JAMES LEBAMOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 JOHN KISSINGER DR, WABASH, IN 46992-1648
(260) 563-3131
(260) 482-4442
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
(260) 428-4440
(260) 482-4442
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01036569
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000191935
BC/BS
IN
05
—
200036420A
—
IN
01
—
930106017
RAILROAD MEDICARE
IN
Enumeration date
12/19/2005
Last updated
04/21/2024
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