Individual
DR. MICHAEL L. LASTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 4TH AVE SW, PIPESTONE, MN 56164-1455
(507) 825-5700
(507) 825-4752
Mailing address
920 4TH AVE SW, PIPESTONE, MN 56164-1455
(507) 825-5700
(507) 825-4752
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23174
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080056192
RR MEDICARE
—
05
—
1912212
—
IA
05
—
7788113
—
SD
05
—
867592900
—
MN
Enumeration date
04/13/2006
Last updated
09/27/2013
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