MEDICARE: DR. ROBERT JOSEPH LEJAWA D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	49846-021	WI
2	207Q00000X	Family Medicine Physician	N1731	TX
3	207Q00000X	Family Medicine Physician	2019-00158	NC

General Provider Information

NPI Number	:	1265592596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JOSEPH LEJAWA D.O.

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	844-266-8268
Fax Number	:

Provider Business Practice Location Address
First Line	:	8645 RACHEL FREEMAN WAY
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-9567
Country	:	US
Telephone Number	:	704-316-3608
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	12/03/2025

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