Healthcare Provider Details

I. General information

NPI: 1790150175
Provider Name (Legal Business Name): MONICA CERONE M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2015
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DRIVE ROOM 4601
MORGANTOWN WV
26506
US

IV. Provider business mailing address

PO BOX 763
MORGANTOWN WV
26507-0763
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-6900
  • Fax:
Mailing address:
  • Phone: 800-541-4009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number28602
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: