Healthcare Provider Details

I. General information

NPI: 1659433811
Provider Name (Legal Business Name): VICTOR BOHDON LEBEDOVYCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 04/12/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER CMR 402
APO AE
09180
DE

IV. Provider business mailing address

BOX 753 CMR 402
APO AE
09180
DE

V. Phone/Fax

Practice location:
  • Phone: 314-486-8214
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301028746
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: