Individual
PETER LASATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11012 E 13 MILE RD STE 112, WARREN, MI 48093-2546
(586) 573-6880
Mailing address
4000 WELLNESS DR, MIDLAND, MI 48670-0001
(844) 832-1956
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301105463
MI
207X00000X
Orthopaedic Surgery Physician
65214
MN
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381958736
—
MI
01
—
BCBSM
0E06376
—
Enumeration date
06/17/2014
Last updated
01/28/2026
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