Individual
DR. MARIO LUCERO
Active
Individual
DR. MARIO LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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