Provider Demographics
NPI:1881905826
Name:LEBEIS, CHRISTOPHER W (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:W
Last Name:LEBEIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21 DONALD B DEAN DR STE 1
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3234
Mailing Address - Country:US
Mailing Address - Phone:207-518-6600
Mailing Address - Fax:207-541-7445
Practice Address - Street 1:21 DONALD B DEAN DR STE 1
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3234
Practice Address - Country:US
Practice Address - Phone:207-518-6600
Practice Address - Fax:207-541-7445
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD21253208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology