Provider Demographics
NPI:1861913147
Name:CERNA URRUTIA, LUIS ERNESTO (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ERNESTO
Last Name:CERNA URRUTIA
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 1:5051 GREENSPRING AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4358
Mailing Address - Country:US
Mailing Address - Phone:410-601-7790
Mailing Address - Fax:
Practice Address - Street 1:5051 GREENSPRING AVE STE 304
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4358
Practice Address - Country:US
Practice Address - Phone:410-601-7790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD0102130207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program