Individual
DR. ROBERT M. LICATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 COASTAL HORIZONS DR, SHALLOTTE, NC 28470-6094
(910) 754-4515
Mailing address
6200 COTTAGE CREEK RD, SOUTHPORT, NC 28461-2983
(571) 216-1272
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0101027066
VA
2084P0800X
Psychiatry Physician
Primary
2014-01510
NC
Other
Enumeration date
01/11/2007
Last updated
08/12/2015
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