MEDICARE: DR. ROBERT F. LEBOW M.D.,

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	01026950A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000087200	OTHER	IN	ANTHEM BLUE CROSS BLUE SH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356395107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT F. LEBOW M.D.,

Provider Business Mailing Address
First Line	:	907 E MICHIGAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-3625
Country	:	US
Telephone Number	:	317-262-0950
Fax Number	:	317-267-0244

Provider Business Practice Location Address
First Line	:	907 E MICHIGAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-3625
Country	:	US
Telephone Number	:	317-262-0950
Fax Number	:	317-267-0244

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	12/22/2019

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