Provider Demographics
NPI:1780944702
Name:CERDA, LUIS MARIANO (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:MARIANO
Last Name:CERDA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:502 ELM ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2512
Mailing Address - Country:US
Mailing Address - Phone:505-843-2525
Mailing Address - Fax:505-843-2819
Practice Address - Street 1:502 ELM ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2512
Practice Address - Country:US
Practice Address - Phone:505-843-2525
Practice Address - Fax:505-843-2819
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2023-1195208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty