Individual
MARYALICE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
333 N 1ST ST STE 240, BOISE, ID 83702-6132
(208) 338-8900
Mailing address
333 N 1ST ST STE 240, BOISE, ID 83702-6132
(208) 338-8900
(208) 947-1190
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M14439
ID
Other
Enumeration date
04/29/2013
Last updated
12/31/2025
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