Individual
KATHLEEN MARIE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4411 THE 25 WAY NE, SUITE 150, ALBUQUERQUE, NM 87109-5857
(505) 332-6900
(505) 332-6921
Mailing address
4411 THE 25 WAY NE, SUITE 150, ALBUQUERQUE, NM 87109-5857
(505) 332-6900
(505) 332-6921
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD2007-0258
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2258272
MEDICARE GROUP
NM
05
—
45138
—
NM
05
—
52713
—
NM
05
—
98431366
—
NM
05
—
L0634
—
NM
Enumeration date
06/14/2007
Last updated
10/18/2007
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