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:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639173115 | NPPES |
| West Virginia | MEDICAID | 0049852000 |
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