Lacerna, Mario Dante

Lacerna, Mario Dante is an individual health care provider with primary practice located at 1501 W Chisholm St , Alpena MI 49707-1401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Lacerna, Mario Dante can be contacted via phone (888) 356-7151.

Contact Information

Primary practice address
1501 W Chisholm St Alpena MI 49707-1401
Phone: (888) 356-7151
Fax: (989) 356-8117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 4301059592 Michigan
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X ME111595 Florida

Profile Details

NPI number 1326130725
LBN Legal business name Lacerna, Mario Dante
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2006
Last updated Dec 12th, 2013 - about 13 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 1326130725 NPPES
Michigan MEDICAID 4303114
Michigan MEDICAID 4375200
Michigan Other FT108Y

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