Provider Demographics
NPI:1821074907
Name:CERAME, MARIO A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:A
Last Name:CERAME
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 1:2655 NORTHWINDS PARKWAY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA,
Mailing Address - State:GA
Mailing Address - Zip Code:30009
Mailing Address - Country:US
Mailing Address - Phone:770-643-5522
Mailing Address - Fax:
Practice Address - Street 1:2655 NORTHWINDS PKWY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-2280
Practice Address - Country:US
Practice Address - Phone:770-643-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242809208600000X
NC32479208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00328039OtherRAILROAD MEDICARE
NC5589OtherPARTNERS MEDICARE CHOICE
NC5702377OtherCIGNA HEALTHCARE
NC5901023OtherAETNA
NC8921852Medicaid
NC1700504OtherUNITED HEALTHCARE
NC67401429OtherCHAMPUS/TRICARE
NC21852OtherBCBS
NCD6987OtherMEDCOST
NC204149BMedicare PIN
NC5702377OtherCIGNA HEALTHCARE