Individual
DR. G. MICHAEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 MILLS AVE STE 300, LAS VEGAS, NM 87701-4169
(505) 425-9311
(505) 425-9047
Mailing address
105 MILLS AVE STE 300, LAS VEGAS, NM 87701-4169
(505) 425-9311
(505) 425-9047
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
NM81-77
NM
363LP2300X
Primary Care Nurse Practitioner
CNP-01651
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991
LOVELACE
NM
01
—
201006000
PRESBYTERIAN HEALTH PLAN
NM
01
—
50013
HMO OF NEW MEXICO
NM
05
—
NM00007070
—
NM
01
—
NM001568
BLUE CROSS BLUE SHIELD
NM
Enumeration date
01/03/2007
Last updated
03/05/2025
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