Individual
MR. ANTONIO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9100 BROMBACH ST, HAMTRAMCK, MI 48212-3473
(313) 972-9000
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-2892
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
163W00000X
Registered Nurse
4704289261
MI
207R00000X
Internal Medicine Physician
Primary
4301513129
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
05/15/2007
Last updated
12/19/2025
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