Provider Demographics
NPI:1285724310
Name:SCHWENDAU, LEO A (MD)
Entity type:Individual
Prefix:DR
First Name:LEO
Middle Name:A
Last Name:SCHWENDAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 950187
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0187
Mailing Address - Country:US
Mailing Address - Phone:502-238-2801
Mailing Address - Fax:502-238-2835
Practice Address - Street 1:400 BLANKENBAKER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1850
Practice Address - Country:US
Practice Address - Phone:502-554-4925
Practice Address - Fax:502-244-9860
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY27341208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64273410Medicaid
KY00162027Medicare PIN