Organization
MARDEN B LACUESTA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARDEN B LACUESTA MD (PRESIDENT)
(419) 586-2523
Entity
Organization
Contact information
Practice address
718 E WAYNE ST, CELINA, OH 45822-1356
(419) 586-2523
(419) 584-1617
Mailing address
718 E WAYNE ST, CELINA, OH 45822-1356
(419) 586-2523
(419) 584-1617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35043441
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0396905
—
OH
Enumeration date
11/15/2010
Last updated
11/15/2010
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