DR. MARIO LUCERO (NPI# 1639173115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639173115 |
| Entity Type | Individual |
| Full Name | DR. MARIO LUCERO |
| Credential | MD |
| Practice Address |
Route 16, Main Street War WV 24892 |
| Practice Telephone | 3044251768 |
| Practice Fax Number | 3044253912 |
| Mailing Telephone | 3044251768 |
| Mailing Fax Number | 3044253912 |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2008-03-13 |
| NPI Deactivation Date | 03/15/2006 |
| NPI Reactivation Date | 2006-04-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 170100000X | Medical Genetics, Ph.D. Medical Genetics | WV13411 | WV | Other Service Providers |
| N | 171W00000X | Contractor | WV 13411 | WV | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0049852000 | 05 |
| Street Address |
ROUTE 16, MAIN STREET |
| City | WAR |
| State | WV |
| Zip Code | 24892 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841699139 | Brenda Beach | Nurse Practitioner | 14197 Rocket Boys Drive, War, WV 24892 | 2014-08-22 |
| 1386925717 | Bobbi Sue Greer | Pharmacist | 14025 Rocket Boys Drive, War, WV 24892 | 2011-08-30 |
| 1487848792 | Sabrina Marie Ray | Pharmacist | 11880 Main St, War, WV 24892 | 2007-08-29 |
| 1285751586 | Mcdowell Pharmacy Inc | Pharmacy | Rt 16 Main St, War, WV 24892 | 2007-03-23 |
| 1619068145 | War Family Clinic | Family Medicine | 16 Main Street, War, WV 24892 | 2006-09-28 |
| 1942266887 | Mahesh B. Patel | Clinic/Center | Hc 32 Box 86a, War, WV 24892 | 2006-04-20 |
| 1336148170 | Dry Fork Squad | Ambulance | Route 16 Main St, War, WV 24892 | 2005-07-14 |
| 1356755870 | Whitney Renee Smith | Pharmacist | 14025 Rocket Boys Drive, War, WV 24892 | 2014-06-12 |
| 1447218458 | Sergio Capuno Macatangay | General Practice | 11710 Main St, War, WV 24892-0250 | 2006-05-02 |
| 1073694949 | Isabelita T De Mesa | Family Medicine | Rt 16 Main Street, War, WV 24892-0459 | 2006-10-18 |
| Find all providers in zip 24892 | ||||
| Taxonomy Code | 170100000X |
| Grouping | Other Service Providers |
| Classification | Medical Genetics, Ph.D. Medical Genetics |
| A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |
| Notes: A general certificate was first issued by ABMS in 1982. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346857257 | Mark James Tabor | Medical Genetics, Ph.D. Medical Genetics | 418 Coolidge Avenue #42, Holden, WV 25625-0082 | 2020-09-24 |
| 1528089703 | Panhandle Medical Assoc Pllc | Medical Genetics, Ph.D. Medical Genetics | 65 Health Care Ln, Martinsburg, WV 25401-4006 | 2006-07-22 |
Please comment or provide details below to improve the information on DR. MARIO LUCERO.
| 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.