Provider Demographics
NPI:1912962184
Name:LEHMAN, DAVID BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRUCE
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 CENTRAL AVE NE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-2968
Mailing Address - Country:US
Mailing Address - Phone:763-572-5700
Mailing Address - Fax:763-782-8100
Practice Address - Street 1:4000 CENTRAL AVE NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-2968
Practice Address - Country:US
Practice Address - Phone:763-572-5700
Practice Address - Fax:763-782-8100
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33793207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4115623OtherAETNA
MN1000841OtherPREFERRED ONE
MN107304OtherUCARE
MNHP13805OtherHEALTHPARTNERS
MN08F55LEOtherBCBS OF MN
MN325302300Medicaid
MN21533OtherAMERICA'S PPO
MN6603852OtherMEDICA UC
MN0120319OtherMEDICA
MN6603852OtherMEDICA UC
MNHP13805OtherHEALTHPARTNERS
MNB49424Medicare UPIN