Individual
GERARDO C LOPEZ
Active
Individual
GERARDO C LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
17559
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720850
BLUE CROSS BLUE SHEILD
WV
05
—
0081763000
—
WV
01
—
WV17559A
HEALTH PLAN
WV
Enumeration date
05/16/2006
Last updated
07/21/2022
Update your record
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