Lucero, Mario

Lucero, Mario is an individual health care provider with primary practice located at Route 16, Main Street , War WV 24892. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Contractor, Other Service Providers / Medical Genetics, Ph.D. Medical Genetics. Other Service Providers / Medical Genetics, Ph.D. Medical Genetics is his primary health care specialty. Lucero, Mario can be contacted via phone (304) 425-1768.

Contact Information

Primary practice address
Route 16, Main Street War WV 24892
Phone: (304) 425-1768
Fax: (304) 425-3912
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X WV 13411 West Virginia
Other Service Providers / Medical Genetics, Ph.D. Medical Genetics 170100000X WV13411 West Virginia

Profile Details

NPI number 1639173115
LBN Legal business name Lucero, Mario
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Mar 13th, 2008 - about 16 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 1639173115 NPPES
West Virginia MEDICAID 0049852000

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