Provider Demographics
NPI:1750800553
Name:LEBEDEVSKIY, OLGA IVANOVNA (MD)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:IVANOVNA
Last Name:LEBEDEVSKIY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1593 E POLSTON AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-5326
Mailing Address - Country:US
Mailing Address - Phone:208-262-2300
Mailing Address - Fax:208-262-2390
Practice Address - Street 1:750 N SYRINGA ST STE 205
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-5275
Practice Address - Country:US
Practice Address - Phone:208-262-0945
Practice Address - Fax:208-415-0150
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2024-09-13
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Provider Licenses
StateLicense IDTaxonomies
IDM-17393208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery