IAN MUKAND-CERRO (NPI# 1316259435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316259435 |
| Entity Type | Individual |
| Full Name | IAN MUKAND-CERRO |
| Credential | M.D. |
| Practice Address |
417 State St Ste 439 Bangor ME 04401-6635 |
| Practice Telephone | 2079418200 |
| Practice Fax Number | 2079904848 |
| Mailing Telephone | 2079418200 |
| Mailing Fax Number | 2079904848 |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2018-11-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
28520 | WV | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
258041 | MA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 94 Brookshire Ln, Beckley, WV 258016765 | 3042522673 |
| Street Address |
417 STATE ST STE 439 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-6635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396701322 | Marek Skacel | Specialist | 417 State St Ste 439, Bangor, ME 04401-6635 | 2006-04-26 |
| 1700258894 | Rima Kanhoush | Specialist | 417 State St Ste 439, Bangor, ME 04401-6635 | 2015-10-28 |
| 1801201967 | Chelsey Marie Gracia | Pathology | 417 State St Ste 439, Bangor, ME 04401-6635 | 2014-06-27 |
| 1235561887 | Lindsay Williams | Pathology | 417 State St Ste 439, Bangor, ME 04401-6635 | 2013-08-06 |
| 1730109117 | Irwin Gross | Specialist | 417 State St Ste 439, Bangor, ME 04401-6635 | 2006-07-20 |
| 1982624326 | Carol Trask | Specialist | 417 State St Ste 439, Bangor, ME 04401-6635 | 2006-07-20 |
| 1538189188 | David Renedo | Specialist | 417 State St Ste 439, Bangor, ME 04401-6635 | 2006-07-19 |
| 1316967979 | Stephen Pfister | Specialist | 417 State St Ste 439, Bangor, ME 04401-6635 | 2006-07-19 |
| 1952321507 | Richard Riemersma | Specialist | 417 State St Ste 439, Bangor, ME 04401-6635 | 2006-07-19 |
| 1053331637 | John Kaiser | Specialist | 417 State St Ste 439, Bangor, ME 04401-6635 | 2006-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316267990 | Rachel Gormley | Dermatology | 50 Sewall St, Portland, ME 04102-2645 | 2010-06-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.