Individual
CARLOS P. LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
PMG URGENT CARE, 5901 HARPER DRIVE NE, ALBUQUERQUE, NM 87109
(505) 823-8519
(505) 823-8355
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
76-224
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8287
—
NM
Enumeration date
07/26/2006
Last updated
08/14/2008
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