Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 60270 | MN |
Y | 207VE0102X | Reproductive Endocrinologist | 60270 | MN |
NPI | 1194818245 |
---|---|
Provider Name | Dan I Lebovic |
First Address | Minneapolis, MN 55407-1544 |
Second Address | Minneapolis, MN 55407-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 15/08/2016 |