Individual
ROBERT LACOSTE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
26811 RYAN RD, WARREN, MI 48091-4075
(586) 755-4433
(586) 755-6655
Mailing address
26811 RYAN RD, WARREN, MI 48091-4075
(586) 755-4433
(586) 755-6655
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301050294
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4290885
—
MI
Enumeration date
06/15/2006
Last updated
07/08/2007
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