Provider Demographics
NPI:1033174610
Name:CERUL, MAURICE SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:SAMUEL
Last Name:CERUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SHADY AVE
Mailing Address - Street 2:SUITE B-104
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4409
Mailing Address - Country:US
Mailing Address - Phone:412-361-4144
Mailing Address - Fax:412-687-3949
Practice Address - Street 1:401 SHADY AVE
Practice Address - Street 2:SUITE B-104
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4409
Practice Address - Country:US
Practice Address - Phone:412-361-4144
Practice Address - Fax:412-687-3949
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD008281E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01678305Medicaid
B35291Medicare ID - Type Unspecified