MEDICARE: DR. ROBERT LACIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	9500123	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477523082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT LACIN MD

Provider Business Mailing Address
First Line	:	4207 LAKE BOONE TRL
Second Line	:	SUITE 220
City	:	RALEIGH
State	:	NC
Zip	:	27607-6684
Country	:	US
Telephone Number	:	919-784-1410
Fax Number	:	919-784-1409

Provider Business Practice Location Address
First Line	:	5838 SIX FORKS RD
Second Line	:	SUITE 100
City	:	RALEIGH
State	:	NC
Zip	:	27609-3885
Country	:	US
Telephone Number	:	919-785-3400
Fax Number	:	919-783-7778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	09/30/2014

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