Basic Information
| Provider Information | |||||||||
| NPI: | 1912962184 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEHMAN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | BRUCE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4000 CENTRAL AVE NE | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA HEIGHTS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554212968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7635725700 | ||||||||
| FaxNumber: | 7637828100 | ||||||||
| Practice Location | |||||||||
| Address1: | 4000 CENTRAL AVE NE | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA HEIGHTS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554212968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7635725700 | ||||||||
| FaxNumber: | 7637828100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2006 | ||||||||
| LastUpdateDate: | 04/11/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 33793 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 4115623 | 01 | MN | AETNA | OTHER | 1000841 | 01 | MN | PREFERRED ONE | OTHER | 107304 | 01 | MN | UCARE | OTHER | HP13805 | 01 | MN | HEALTHPARTNERS | OTHER | 08F55LE | 01 | MN | BCBS OF MN | OTHER | 325302300 | 05 | MN | MEDICAID | 21533 | 01 | MN | AMERICA'S PPO | OTHER | 6603852 | 01 | MN | MEDICA UC | OTHER | 0120319 | 01 | MN | MEDICA | OTHER |