Provider Demographics
NPI:1043451008
Name:RASBERRY, MELISSA LALANDE (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:LALANDE
Last Name:RASBERRY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:501 DR MICHAEL DEBAKEY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5724
Mailing Address - Country:US
Mailing Address - Phone:337-312-8258
Mailing Address - Fax:337-312-6711
Practice Address - Street 1:1920 W SALE RD
Practice Address - Street 2:BLDG F, SUITE 2
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-2400
Practice Address - Country:US
Practice Address - Phone:337-474-2856
Practice Address - Fax:337-480-0645
Is Sole Proprietor?:No
Enumeration Date:2009-03-20
Last Update Date:2017-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA203911207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1990931Medicaid
LA246975YH5NMedicare PIN
LA1990931Medicaid