Individual
MARIO CESARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1471 EAST BELLTINE NE, STE 201, GRAND RAPIDS, MI 49525
(616) 685-8620
Mailing address
245 STATE ST SE, STE 1A, GRAND RAPIDS, MI 49503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301091589
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036106961
—
IL
Enumeration date
02/20/2006
Last updated
09/11/2012
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