Carlos Estanislao Lucero, MD | |
403 Carriage Drive, Beckley, WV 25801 | |
(304) 255-7456 | |
(304) 255-5899 |
Full Name | Carlos Estanislao Lucero |
---|---|
Gender | Male |
Speciality | Pediatrics - Developmental - Behavioral Pediatrics |
Location | 403 Carriage Drive, Beckley, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033164645 | NPI | - | NPPES |
0112021000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | 10355 (West Virginia) | Primary |
Entity Name | Scotland Memorial Hospital, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033103767 PECOS PAC ID: 0648208504 Enrollment ID: O20031105000382 |
Mailing Address | Practice Location Address |
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Carlos Estanislao Lucero, MD 403 Carriage Dr, Beckley, WV 25801-2805 Ph: (304) 255-7456 | Carlos Estanislao Lucero, MD 403 Carriage Drive, Beckley, WV 25801 Ph: (304) 255-7456 |
Dr. Petaiah Mohan, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 194 Carriage Dr, Beckley, WV 25801 Phone: 304-255-6051 Fax: 304-255-6051 | |
Ramon Lacanilao, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 30 Mallard Court, Beckley, WV 25801 Phone: 304-255-0800 Fax: 304-255-1040 | |
Kim D Bennett, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 252 Rural Acres Dr, Beckley, WV 25801 Phone: 304-252-8551 Fax: 304-252-1790 | |
Dr. Michele Dawn Staton, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2401 S Kanawha St, Suite 110a, Beckley, WV 25801 Phone: 304-929-4646 Fax: 304-929-4649 | |
Dr. Malik Hamdan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1710 Harper Rd, Beckley, WV 25801 Phone: 304-256-4100 Fax: 304-254-3016 | |
Dr. Saraswathi Mohan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 194 Carriage Dr, Beckley, WV 25801 Phone: 304-255-6051 Fax: 304-255-6051 |