Individual
DR. EDGAR A. LOPEZ-SUESCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
726 ZORN AVE APT 1, LOUISVILLE, KY 40206-1447
(502) 891-8986
Mailing address
726 ZORN AVE APT 1, LOUISVILLE, KY 40206-1447
(502) 891-8986
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
202C00000X
Independent Medical Examiner Physician
18215
KY
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
18215
KY
208D00000X
General Practice Physician
18215
KY
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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