Lacuesta, Marden B

Lacuesta, Marden B is an individual health care provider with primary practice located at 718 East Wayne Street , Celina OH 45822. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Lacuesta, Marden B can be contacted via phone (419) 586-2523.

Contact Information

Primary practice address
718 East Wayne Street Celina OH 45822
Fax: (419) 584-1617
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35043441 Ohio
Allopathic & Osteopathic Physicians / Surgery 208600000X 35043441 Ohio

Profile Details

NPI number 1417038118
LBN Legal business name Lacuesta, Marden B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417038118 NPPES
Ohio MEDICAID 0396905

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