Provider Demographics
NPI:1477523082
Name:LACIN, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:LACIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4207 LAKE BOONE TRL
Mailing Address - Street 2:SUITE 220
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6684
Mailing Address - Country:US
Mailing Address - Phone:919-784-1410
Mailing Address - Fax:919-784-1409
Practice Address - Street 1:5838 SIX FORKS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3885
Practice Address - Country:US
Practice Address - Phone:919-785-3400
Practice Address - Fax:919-783-7778
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2014-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9500123207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC895050HMedicaid
NC895050HMedicaid
NC2210029BMedicare ID - Type Unspecified