WAYNE FREDERICK LEEBAW MD NPI 1033178405

NPI Information

NPI: 1033178405
Provider Name: WAYNE FREDERICK LEEBAW, MD
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
7701 YORK AVE S
SUITE 180
EDINA, MN
ZIP 55435
Phone: (952) 927-7810
Get Directions

Wayne Frederick Leebaw, MD is a specialist in Edina, MN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Wayne Frederick Leebaw, MD NPI is 1033178405. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7701 YORK AVE S
SUITE 180
EDINA, MN
ZIP 55435-845
Phone: (952) 927-7810
Fax: (952) 927-6309

The enumeration date for this NPI number is 3/22/2006 and was last updated on 5/6/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		23267	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0256006	OTHER	MINNESOTA	SELECT CARE
2	3317283	OTHER	MINNESOTA	MEDICA CHOICE
3	410999025	OTHER	MINNESOTA	TRICARE
4	3300003	OTHER	MINNESOTA	MEDICA PRIMARY
5	656388100	MEDICAID	MINNESOTA
6	HP13803	OTHER	MINNESOTA	HEALTH PARTNERS
7	104082	OTHER	MINNESOTA	PATIENT CHOICE
8	120263C626	OTHER	MINNESOTA	UCARE
9	21002	OTHER	MINNESOTA	AMERICA'S PPO
10	960540799004	OTHER	MINNESOTA	PREFERRED ONE
11	53967LE	OTHER	MINNESOTA	BLUE CROSS BLUE SHIELD
12	A94303	MEDICARE UPIN
13	46000068	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA
14	110032090	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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