Ian Mukand-Cerro, M.D.

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

28520 Issued in WV

Practice address

417 State St Ste 439
Bangor, ME 04401-6635

Phone

(207) 941-8200

Fax

(207) 990-4848

NPI assigned

Jul 6, 2010

Last updated

Nov 28, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dahl Chase Pathology Associates, PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Bangor, ME
  • NPI 1669870705
  NPD (past)
• Northeast Dermatopathology Institute

  • Clinical Medical Laboratory
  • Clarks Summit, PA
  • NPI 1477526655
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1316259435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 STATE ST STE 439",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016635",
            "telephone_number": "207-941-8200",
            "fax_number": "207-990-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST STE 439",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016635",
            "telephone_number": "207-941-8200",
            "fax_number": "207-990-4848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Brookshire Ln",
            "address_purpose": "LOCATION",
            "city": "Beckley",
            "state": "WV",
            "postal_code": "258016765",
            "country_code": "US",
            "telephone_number": "304-252-2673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUKAND-CERRO",
        "first_name": "IAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WV",
            "license": "28520",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "258041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne P Mowry, SLP
• Brian Moynihan, LCPC
• Mary Therese Moynihan, LCSW
• Paula Louise Mroz, RNC
• Judith Muhlin, LCSW
• Cassandra Lynn Muldoon, MD
• Dennis Mullins, P.T.
• Kathleen Mulrenin, PHD
• Rachel Anne Muncey, PMHNP
• Clare Mundell, PH.D.

• Dermatopathology Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Dermatopathology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.