# DR. MARY RUTH MOTOMAL LOPEZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1154371912
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 22265 | WV | Yes |

## Other

- **Enumeration date:** 05/11/2006
- **Last updated:** 04/12/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3810007064 | — | WV |
| 01 | — | P00966052 | RAIL ROAD MEDICARE | WV |