Individual
DR. MARIO LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ROUTE 16, MAIN STREET, WAR, WV 24892
(304) 425-1768
(304) 425-3912
Mailing address
ROUTE 16, MAIN STREET, WAR, WV 24892
(304) 425-1768
(304) 425-3912
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
WV13411
WV
171W00000X
Contractor
WV 13411
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0049852000
—
WV
Enumeration date
06/13/2005
Last updated
03/13/2008
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