Individual
MARVIN J LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 NEVINS ST, STE 201, BRIGHTON, MA 02135
(617) 789-2442
(617) 789-4207
Mailing address
77 WARREN ST, RM 339, BRIGHTON, MA 02135
(617) 562-5359
(617) 562-5415
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
76718
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3102076
—
MA
Enumeration date
09/21/2005
Last updated
02/23/2009
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